Individual
DR. ADEL S. YAACOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3900 ST FRANCIS WAY STE 200, LAFAYETTE, IN 47905-4940
(765) 765-7752
(765) 775-2831
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01039558
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200205010
—
IN
Enumeration date
07/19/2006
Last updated
09/29/2023
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