Individual
FADI TAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 N RITTER AVE STE 340, INDIANAPOLIS, IN 46219-3049
(317) 355-5870
Mailing address
1400 N RITTER AVE STE 340, INDIANAPOLIS, IN 46219-3049
(317) 355-5870
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
01085904A
IN
207RX0202X
Medical Oncology Physician
Primary
01085904A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300050784
—
IN
Enumeration date
03/30/2018
Last updated
10/15/2024
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