# MR. ABDOLAZIZ M ARDALAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1487761607
- **Gender:** Man
- **Credential:** M.D

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 010267201 | IN | Yes |

## Other

- **Enumeration date:** 08/24/2006
- **Last updated:** 09/06/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000079426 | ANTHEM BLUE SHIELD | IN |
| 05 | — | 100367790A | — | IN |