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Individual

DR. TARIQ HUSSNI ALI ENEZATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2325 18TH ST STE 130, COLUMBUS, IN 47201-5387
(812) 379-2020
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036157953
IL
207R00000X
Internal Medicine Physician
2014027804
MO
207R00000X
Internal Medicine Physician
2017-02439
NC
207RC0000X
Cardiovascular Disease Physician
036157953
IL
207RC0000X
Cardiovascular Disease Physician
2014027804
MO
207RC0000X
Cardiovascular Disease Physician
2017-02439
NC
207RI0011X
Interventional Cardiology Physician
Primary
01098160A
IN
207RI0011X
Interventional Cardiology Physician
036157953
IL
207RI0011X
Interventional Cardiology Physician
2017-02439
NC

Other

Enumeration date
08/04/2011
Last updated
10/30/2025
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