Organization
HEALTHY AGING ENTERPRISE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARWAN MUSTAKLEM M.D. (MBR)
(317) 985-9501
Entity
Organization
Contact information
Practice address
10926 BELLE PLAINE BLVD, FISHERS, IN 46037-7113
(317) 985-9501
Mailing address
10926 BELLE PLAINE BLVD, FISHERS, IN 46037-7113
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
02/09/2016
Last updated
02/09/2016
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