Individual
FAYEZ S TUSHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7250 CLEARVISTA DR, SUITE 120, INDIANAPOLIS, IN 46256-4640
(317) 621-5676
(317) 621-5678
Mailing address
920 N SHADELAND AVE, SUITE G1, INDIANAPOLIS, IN 46219-4817
(317) 355-9783
(317) 355-9760
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
01023737A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100318520A
—
IN
Enumeration date
06/13/2005
Last updated
10/30/2009
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