MEDICARE: DR. BASHAR KARAKASH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	01061137A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01214634	OTHER	IN	RR MEDICARE PTAN

General Provider Information

NPI Number	:	1215932819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BASHAR KARAKASH M.D.

Provider Business Mailing Address
First Line	:	6626 E 75TH STREET
Second Line	:	SUITE 500
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2890
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7250 CLEARVISTA DR
Second Line	:	SUITE 120
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-4692
Country	:	US
Telephone Number	:	317-621-5676
Fax Number	:	317-621-5678

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	12/03/2014

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