Individual
TAREK KTELEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1107 S TILLOTSON AVE, MUNCIE, IN 47304-4517
(765) 717-5399
Mailing address
1107 S TILLOTSON AVE, MUNCIE, IN 47304-4517
(765) 717-5399
(855) 792-0451
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
2006018669
MO
207RR0500X
Rheumatology Physician
Primary
01068046A
IN
207RR0500X
Rheumatology Physician
10801
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200980090
—
IN
Enumeration date
04/03/2007
Last updated
02/10/2025
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