Individual
TERESA ANN OLDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2425 MILO B. SAMPSON LANE, BLOOMINGTON, IN 47408-1398
(812) 349-5074
(812) 349-5130
Mailing address
2425 MILO B. SAMPSON LANE, BLOOMINGTON, IN 47408-1398
(812) 349-5074
(812) 349-5046
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01062429A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000561415
ANTHEM BCBS
IN
05
—
200894620
—
IN
Enumeration date
02/20/2007
Last updated
09/06/2024
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