Individual
MAHMUDA AKHTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
915 MEZZANINE DR, LAFAYETTE, IN 47905-8637
(765) 448-8000
(765) 838-6351
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01089250A
IN
207RN0300X
Nephrology Physician
Primary
01089250A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300078602
—
IN
01
—
815500587
MEDICARE PTAN
IN
01
—
Q00563230
RAILROAD PTAN
IN
Enumeration date
03/20/2018
Last updated
12/29/2023
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