Individual
MAHAM FATIMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1002 WISHARD BLVD STE 2001, INDIANAPOLIS, IN 46202-4164
(317) 944-2801
(317) 968-1417
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01090169A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068010921
MEDICARE PTAN
IN
05
—
300042600
—
IN
Enumeration date
09/16/2020
Last updated
10/11/2023
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