Individual
ISMAIL ABBASI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5215 HOLY CROSS PKWY, MISHAWAKA, IN 46545-1469
(574) 335-5000
Mailing address
PO BOX 6309, SOUTH BEND, IN 46660-6309
(574) 335-8700
(574) 335-0760
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
01032923A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000898827
ANTHEM PROVIDER NUMBER
IN
05
—
200009190
—
IN
Enumeration date
12/27/2005
Last updated
11/24/2014
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