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Individual

DR. OMAR F ISHAQ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
550 UNIVERSITY BLVD, INDIANAPOLIS, IN 46202-5149
(317) 944-2524
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01084508A
IN
2085R0001X
Radiation Oncology Physician
R2886
TX
208D00000X
General Practice Physician
272711-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300041995
IN
05
373940102
TX
Enumeration date
02/05/2010
Last updated
01/25/2022
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