Organization
TAREK KUDAIMI MD, LLC
Active
Organization
TAREK KUDAIMI MD, LLC
Active
Other names
TAREK KUDAIMI MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAREK KUDAIMI MD (OWNER MANAGER)
(219) 836-1310
Entity
Organization
Contact information
Practice address
801 MACARTHUR BLVD, SUITE 305, MUNSTER, IN 46321-2915
(219) 836-1310
(219) 836-0617
Mailing address
801 MACARTHUR BLVD, SUITE 305, MUNSTER, IN 46321-2915
(219) 836-1310
(219) 836-0617
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
01044239
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000095728
ANTHEM
IN
01
—
110182794
RAILROAD MEDICARE
IN
05
—
200191040B
—
IN
01
—
237151
WELLCARE
IN
01
—
3200450
UNITED HEALTH CARE
IN
01
—
90000885
BLUE CROSS BLUE SHIELD ILLINOIS
IL
Enumeration date
01/12/2010
Last updated
01/12/2010
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