Individual
DR. FADEE KUTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8840 CALUMET AVE STE 206, MUNSTER, IN 46321-2546
(219) 836-7723
(219) 836-7726
Mailing address
PO BOX 1103, CROWN POINT, IN 46308-1103
(219) 662-3931
(219) 663-6359
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.072953
IL
207RP1001X
Pulmonary Disease Physician
Primary
01096431A
IN
390200000X
Student in an Organized Health Care Education/Training Program
4301507051
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300116237
—
IN
Enumeration date
07/25/2018
Last updated
08/27/2025
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