Individual
RAYHAN JALAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2600 FERRY ST, LAFAYETTE, IN 47904-3055
(765) 448-8000
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01074356A
IN
207X00000X
Orthopaedic Surgery Physician
251687
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000896530
ANTHEM PROVIDER NUMBER
IN
05
—
201250640
—
IN
Enumeration date
08/02/2012
Last updated
01/14/2021
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