Individual
REHAM ADEL BAGHDADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
279 W 80TH PL, MERRILLVILLE, IN 46410-5491
(219) 738-2180
Mailing address
362 E 125TH PL, CROWN POINT, IN 46307-7546
(219) 789-9429
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
18004011
IN
152W00000X
Optometrist
Primary
4901005012
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18004011
LICENSE
IN
Enumeration date
09/06/2016
Last updated
03/17/2018
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