Individual
DR. BASSEM I RAZZOUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(317) 338-4673
(317) 338-3227
Mailing address
10330 N MERIDIAN ST, SUITE 201, INDIANAPOLIS, IN 46290-1024
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
01063092A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119428
—
MS
05
—
006737242
—
VA
05
—
009913930
—
AL
05
—
0535740
—
IA
05
—
060502401
—
TX
05
—
100017620A
—
OK
05
—
1135341 00
—
WY
05
—
1550469
—
LA
05
—
200179550A
—
IN
05
—
205028707
—
MO
05
—
3898886
—
TN
05
—
422400000
—
ME
05
—
64928971
—
KY
05
—
7611308
—
NC
05
—
Q30048
—
SC
Enumeration date
05/27/2005
Last updated
04/11/2012
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