Individual
RAFAT ABONOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1044 W WALNUT ST RM 202, INDIANAPOLIS, IN 46202-5254
(317) 274-0843
(317) 944-3349
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01043602A
IN
207RH0000X
Hematology (Internal Medicine) Physician
01043602
IN
207RH0000X
Hematology (Internal Medicine) Physician
Primary
01043602A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000109892
ANTHEM PTAN
IN
05
—
200028120
—
IN
Enumeration date
04/20/2006
Last updated
03/05/2025
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