Individual
ALAA KASSIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MSCBI
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-2000
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01090151A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M400014568
MEDICARE PTAN
IN
Enumeration date
04/05/2022
Last updated
08/17/2023
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