Individual
DR. ABDALI S. JAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
610 N SAWYER RD, KENDALLVILLE, IN 46755-2566
(260) 347-5592
(260) 347-5155
Mailing address
PO BOX 236, LAGRANGE, IN 46761-0236
(260) 463-2133
(260) 463-3775
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01051996A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200301010
—
IN
01
—
4301070135
MICHIGAN LICENSE
MI
Enumeration date
09/13/2005
Last updated
06/21/2022
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