Individual
SUBRIE AHMED ABEDALLHADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1210 MEDICAL ARTS BLVD # A, SUITE 105, ANDERSON, IN 46011-3461
(765) 298-4660
(765) 298-4926
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01062234A
IN
207RC0000X
Cardiovascular Disease Physician
01062234A
IN
207RI0011X
Interventional Cardiology Physician
Primary
01062234A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200856590
—
IN
01
—
P01214598
RR MEDICARE PTAN
IN
Enumeration date
07/18/2006
Last updated
03/07/2023
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