Individual
ANUM FASIH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2900 16TH ST, BEDFORD, IN 47421-3510
(812) 278-8800
Mailing address
815 MAIN ST, PEORIA, IL 61602-1076
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01082880A
IN
207Q00000X
Family Medicine Physician
125067519
IL
Other
Enumeration date
07/21/2015
Last updated
01/19/2021
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