Individual
MUALLA AKISIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9669 E. 146TH STREET, SUITE 250, NOBLESVILLE, IN 46060-5004
(317) 621-3418
(317) 621-3415
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
01057374A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200472350
—
IN
01
—
P01221073
RR MEDICARE PTAN
IN
Enumeration date
05/26/2006
Last updated
11/27/2023
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