| Organization Name: | ADVANCED INTERNAL MEDICINE LLC |
| NPI Number: | 1124342407 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GREGORY A QUIN (OWNER) |
| Mailing Address: | 302 N Duke St Peru |
| State: | IN US |
| Postal Code: | 469701520 |
| Phone Number: | 7654723944 |
| Fax Number: | 7654723945 |
| NPI Enumeration Date: | 03/16/2010 |
| NPI Last Update Date: | 11/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 01045818 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |