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Individual

ISLAM ABBAS BOLAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3900 ST FRANCIS WAY STE 200, LAFAYETTE, IN 47905-4940
(765) 775-2800
(765) 775-2831
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01064026A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
01064026A
IN
207RI0011X
Interventional Cardiology Physician
016813
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200881960
IN
Enumeration date
12/14/2006
Last updated
02/17/2023
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