Provider Demographics
NPI:1407735244
Name:INDUMATHI MD AND ASSOCIATES PA
Entity type:Organization
Organization Name:INDUMATHI MD AND ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:INDUMATHI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTOPHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-682-6320
Mailing Address - Street 1:131 E REDSTONE AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-5355
Mailing Address - Country:US
Mailing Address - Phone:850-682-6320
Mailing Address - Fax:850-682-6339
Practice Address - Street 1:131 E REDSTONE AVE STE 107
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-5355
Practice Address - Country:US
Practice Address - Phone:850-682-6320
Practice Address - Fax:850-682-6339
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTOPHER MD & ASSOCIATES, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty