Individual
ABDULRAHIM ISMAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2651 E DISCOVERY PKWY, BLOOMINGTON, IN 47408-9059
(812) 353-5222
(812) 353-5262
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01090117A
IN
2084N0400X
Neurology Physician
7345620
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090540860
MEDICARE PTAN
IN
05
—
300075636
—
IN
Enumeration date
04/20/2015
Last updated
06/28/2023
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