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Individual

NISHAT FATIMA ALLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1201 MICHIGAN AVE STE 330, LOGANSPORT, IN 46947-1570
(703) 346-3787
Mailing address
1101 MICHIGAN AVE, LOGANSPORT, IN 46947-1528

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01084938BA
IN
208000000X
Pediatrics Physician
D73171
MD

Other

Enumeration date
06/03/2008
Last updated
01/08/2021
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