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Individual

MIR ABDUL KARIM MOSHREF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2110 LOWER HUNTINGTON RD, FORT WAYNE, IN 46819-1235
(260) 478-9960
(260) 478-9670
Mailing address
2110 LOWER HUNTINGTON RD, FORT WAYNE, IN 46819-1235
(260) 478-9960
(260) 478-9670

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01042546
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000176706
ANTHEM
IN
05
100332850
IN
Enumeration date
09/19/2006
Last updated
12/09/2013
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