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Individual

MOAYYED MOALLEM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1210 MEDICAL ARTS BLVD STE 214, ANDERSON, IN 46011-3439
(765) 298-4300
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
01066336A
IN
207RP1001X
Pulmonary Disease Physician
Primary
01066336A
IN
207RS0012X
Sleep Medicine (Internal Medicine) Physician
01066336A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000620348
ANTHEM
IN
05
200947060
IN
Enumeration date
04/09/2006
Last updated
08/03/2020
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