Organization
TERRE HAUTE PULMONARY & PEDIATRIC CLINIC, LLC
Active
Other names
Shelburn Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TRUPTI A BHUPTANI MD (CO OWNER MD)
(812) 234-6053
Entity
Organization
Contact information
Practice address
557 W BROADWAY ST, SHELBURN, IN 47879-1232
(812) 397-2440
(812) 397-0164
Mailing address
4525 S SPRINGHILL JCT, TERRE HAUTE, IN 47802-4563
(812) 234-6053
(812) 234-1722
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01038772A
IN
207R00000X
Internal Medicine Physician
01055950A
IN
208D00000X
General Practice Physician
01038772A
IN
363LF0000X
Family Nurse Practitioner
71000843A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200391150E
—
IN
Enumeration date
08/19/2006
Last updated
09/29/2016
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