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Individual

DR. JUGNOO HUSAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2560 N. SHADELAND AVE., SUITE A, INDIANAPOLIS, IN 46219-1706
(317) 275-8000
(317) 275-8018
Mailing address
14275 MIDWAY RD, SUITE 400, ADDISON, TX 75001-3614
(317) 275-8000
(610) 271-4245

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01039972A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000372826
ANTHEM
IN
05
200099170A
IN
Enumeration date
12/28/2005
Last updated
05/29/2015
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