Provider Demographics
NPI:1730178906
Name:MARKET, PAULA J (MD)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:J
Last Name:MARKET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2723 S 7TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-3558
Mailing Address - Country:US
Mailing Address - Phone:812-238-1730
Mailing Address - Fax:812-242-1565
Practice Address - Street 1:4001 WABASH AVE STE C
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47803-1647
Practice Address - Country:US
Practice Address - Phone:812-877-0506
Practice Address - Fax:812-877-1844
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01044318A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200062000Medicaid
IN254390EMedicare PIN
ING17012Medicare UPIN
INM400040969Medicare PIN