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Individual

DR. HABIB JOHN KOMARI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4033 WILL Z WAY CT, GREENWOOD, IN 46143-9312
(317) 904-0323
Mailing address
4033 WILL Z WAY CT, GREENWOOD, IN 46143-9312

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
01040158A
IN
207RC0000X
Cardiovascular Disease Physician
Primary
01040158A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200002410A
IN
01
P01214627
RR MEDICARE PTAN
IN
Enumeration date
02/14/2006
Last updated
05/05/2016
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