Individual
MAZEN ALAKHRAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3920 ST FRANCIS WAY STE 220, LAFAYETTE, IN 47905-4922
(765) 428-5950
(765) 428-5951
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
01054848A
IN
207RP1001X
Pulmonary Disease Physician
46921
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000623110
ANTHEM PROVIDER NUMBER
IN
05
—
200948240
—
IN
Enumeration date
11/29/2005
Last updated
02/10/2023
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