Healthcare Provider Details

I. General information

NPI: 1487236204
Provider Name (Legal Business Name): AZKAA ZAMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 MAIN ST STE 201
DYER IN
46311-3717
US

IV. Provider business mailing address

919 MAIN ST STE 201
DYER IN
46311-3717
US

V. Phone/Fax

Practice location:
  • Phone: 219-922-3002
  • Fax:
Mailing address:
  • Phone: 219-922-3002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number02009208B
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: