Individual
NASRALLAH HADDAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 N RITTER AVE, SUITE 330, INDIANAPOLIS, IN 46219-3052
(317) 355-1000
(317) 355-5440
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01031715A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000497913
ANTHEM BCBS ID
IN
01
—
000000764838
ANTHEM
IN
05
—
1001764210
—
IN
01
—
P01227340
RR MEDICARE PTAN
IN
Enumeration date
10/01/2006
Last updated
06/18/2015
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