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Individual

FARIBORZ SHAHROOZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9656 SPRUANCE CT, INDIANAPOLIS, IN 46256-9622
(812) 238-7783
(812) 238-4506
Mailing address
9656 SPRUANCE CT, INDIANAPOLIS, IN 46256-9622
(812) 238-7783
(812) 238-4506

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01036398A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200353840
IN
01
300126770
RR MEDICARE
IN
Enumeration date
05/17/2007
Last updated
08/24/2009
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