Individual
NOOR BAKROUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 WALTER SCHOLER DR, LAFAYETTE, IN 47909-6303
(765) 838-6510
(765) 448-8257
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01083973A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300014882
—
IN
01
—
815500474
MEDICARE
IN
Enumeration date
05/21/2018
Last updated
09/27/2022
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