Individual
EZZA FATIMA TARIQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
835 HOSPITAL RD, INDIANA, PA 15701-3629
(724) 357-7000
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-3725
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01097794A
IN
207R00000X
Internal Medicine Physician
Primary
MD486005
PA
208M00000X
Hospitalist Physician
01097794A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300121103
—
IN
Enumeration date
04/04/2021
Last updated
03/30/2026
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