Individual
ALFONSO Q ESTRADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1429 N 6TH ST, TERRE HAUTE, IN 47807-1037
(812) 242-3175
(812) 242-3543
Mailing address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 242-3175
(812) 242-3543
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036-057641
IL
207RC0000X
Cardiovascular Disease Physician
01065735A
IN
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
01065735A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036057641
—
IL
01
—
P00818711
RAILROAD MEDICARE
IN
Enumeration date
03/21/2006
Last updated
03/14/2013
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