Organization
DIABETES ASSOCIATES OF INDIANA P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOAZZAM HABIB MD (OWNER)
(312) 262-6434
Entity
Organization
Contact information
Practice address
9526 PARK MERIDIAN DR, INDIANAPOLIS, IN 46260-1331
(317) 652-9684
Mailing address
9526 PARK MERIDIAN DR, INDIANAPOLIS, IN 46260-1331
(312) 262-6434
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100358590
—
IN
Enumeration date
08/22/2022
Last updated
12/03/2025
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