Organization
UNIVERSITY MEDICAL DIAGNOSTIC ASSOCIATES, INC.
Active
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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