Individual
MARK ALEXANDER FAKHOURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2340 E 10TH ST, INDIANAPOLIS, IN 46201-2008
(317) 633-7360
(317) 633-7302
Mailing address
3401 E RAYMOND ST, INDIANAPOLIS, IN 46203-4744
(317) 788-9769
(317) 781-4868
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01040473
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100381530
—
IN
Enumeration date
10/05/2005
Last updated
04/26/2011
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