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Individual

IMAD E HORANI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2231 CAREW ST, FORT WAYNE, IN 46805-4713
(260) 266-5230
(260) 373-9393
Mailing address
1234 E DUPONT RD, SUITE 3, FORT WAYNE, IN 46825-1545
(260) 373-7875
(260) 373-9705

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01034917
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000084166
BCBS PROVIDER NUMBER
IN
01
000000638370
ANTHEM
IN
01
100006559
RAILROAD MEDICARE
IN
05
100331610
IN
01
2765686001
CIGNA PROVIDER NUMBER
IN
05
3019003
OH
01
4047092
AETNA PROVIDER NUMBER
IN
01
P00785645
MEDICARE RR
IN
Enumeration date
10/20/2005
Last updated
09/23/2013
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