Individual
DR. JACK SHAMOUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1907 W SYCAMORE ST, KOKOMO, IN 46901-5148
(765) 456-5433
Mailing address
10330 N MERIDIAN ST # 300, INDIANAPOLIS, IN 46290-1024
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01070898A
IN
207R00000X
Internal Medicine Physician
125055944
IL
Other
Enumeration date
09/15/2010
Last updated
03/27/2018
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