Individual
TAREQ SALOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
535 BARNHILL DR, INDIANAPOLIS, IN 46202-5116
(317) 948-6942
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01083851A
IN
207RH0003X
Hematology & Oncology Physician
Primary
01083851A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264910408
MEDICARE PTAN
IN
05
—
300037850
—
IN
Enumeration date
07/02/2017
Last updated
03/07/2025
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