Individual
FAROUK KHAIRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9015 E 17TH ST, INDIANAPOLIS, IN 46229-2016
(317) 355-7700
(317) 355-9027
Mailing address
6605 MOSSY ROCK LN, INDIANAPOLIS, IN 46237-2939
(317) 791-9527
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01045094A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000334996
ANTHEM
IN
05
—
200034460
—
IN
01
—
P00140979
RR MEDICARE
IN
Enumeration date
07/26/2006
Last updated
01/03/2020
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