# ALZEIDAN MEDICAL CORPORATION, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821007543
- **Authorized official:** FADI ALZEIDAN MD (PHYSICIAN/OWNER)
- **Authorized official phone:** (219) 769-6639

## Contact information

- **Practice address:** 7863 BROADWAY, MERRILLVILLE, IN 46410-5553
- **Practice address phone:** (219) 769-6639
- **Practice address fax:** (219) 769-0636
- **Mailing address:** 55 E 86TH AVE, PO BOX 10645, MERRILLVILLE, IN 46410-6382
- **Mailing address phone:** (219) 769-1670
- **Mailing address fax:** (219) 738-6714

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 01053003 | IN | Yes |

## Other

- **Enumeration date:** 08/05/2006
- **Last updated:** 08/22/2020