Individual
DR. ANTWAN M MARDINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1530 N 7TH ST, SUITE 111, TERRE HAUTE, IN 47807-1057
(812) 232-9663
(812) 232-2980
Mailing address
2723 S 7TH ST, SUITE A, TERRE HAUTE, IN 47802-3558
(812) 238-1730
(812) 242-1565
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01048595
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00059999
RAILROAD MEDICARE
IN
Enumeration date
02/14/2006
Last updated
02/04/2008
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