Individual
DR. TAREK KUDAIMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 MACARTHUR BLVD, SUITE 305, MUNSTER, IN 46321-2915
(219) 836-1310
(219) 836-0617
Mailing address
801 MACARTHUR BLVD, SUITE 305, MUNSTER, IN 46321-2915
(219) 836-1310
(219) 836-0617
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01044239
IN
207RR0500X
Rheumatology Physician
Primary
01044239
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000095728
ANTHEM
IN
01
—
110182794
RAILROAD MEDICARE
IN
05
—
200191040B
—
IN
01
—
3200450
UNITED HEALTH CARE
IN
01
—
5860647
AETNA
IN
01
—
90000885
BCBS IL
IL
Enumeration date
04/13/2006
Last updated
02/02/2009
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