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Organization

UNIVERSITY MEDICAL DIAGNOSTIC ASSOCIATES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
THOMAS LEE BETLEY (ASSOCIATE VICE CHAIR)
(317) 274-1450
Entity
Organization

Contact information

Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 274-8660
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
(888) 484-3258

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
IN
207R00000X
Internal Medicine Physician
Primary
IN
207RC0000X
Cardiovascular Disease Physician
IN
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
IN
207RG0100X
Gastroenterology Physician
IN
207RH0003X
Hematology & Oncology Physician
IN
207RI0200X
Infectious Disease Physician
IN
207RN0300X
Nephrology Physician
IN
207RP1001X
Pulmonary Disease Physician
IN
207RR0500X
Rheumatology Physician
IN
208U00000X
Clinical Pharmacology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000076157
ANTHEM
IN
05
100465190
IN
05
200397870
IN
05
201004730
IN
Enumeration date
05/09/2006
Last updated
09/13/2023
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