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Individual

JASJIT KAUR MUDHAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1402 E COUNTY LINE RD, INDIANAPOLIS, IN 46227-0963
(317) 887-7805
Mailing address
6626 E 75TH ST, INDIANAPOLIS, IN 46250-2805

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01074159A
IN
208M00000X
Hospitalist Physician
Primary
01074159A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000976727
ANTHEM
IN
05
201243040
IN
01
P01824527
RR PTAN
IN
Enumeration date
03/30/2011
Last updated
05/21/2025
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