Individual
HAJIRAH T ISHAQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
720 ESKENAZI AVE, INDIANAPOLIS, IN 46202-5187
(317) 639-6671
(317) 963-5492
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02007202A
IN
207P00000X
Emergency Medicine Physician
34.015267
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102182636
ANTHEM PTAN
IN
05
—
300076155
—
IN
Enumeration date
03/31/2019
Last updated
03/11/2025
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