Individual
MOHAMMAD R NEKOOMARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3512 S LAFOUNTAIN ST, KOKOMO, IN 46902-3803
(765) 865-6633
(765) 865-6634
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01029903
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100327380
—
IN
05
—
100365080
—
IN
05
—
200932110A
—
IN
01
—
P01270953
RR MEDICARE
IN
Enumeration date
06/04/2006
Last updated
11/30/2016
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