Healthcare Provider Details
I. General information
NPI: 1972698413
Provider Name (Legal Business Name): BEHZAD AALAEI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/03/2006
Last Update Date: 10/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3741 45TH ST
HIGHLAND IN
46322-3008
US
IV. Provider business mailing address
3741 45TH ST
HIGHLAND IN
46322-3008
US
V. Phone/Fax
- Phone: 219-924-7246
- Fax: 219-924-7247
- Phone: 219-924-7246
- Fax: 219-924-7247
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 01048881A |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 01048881A |
| License Number State | IN |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LA0401X |
| Taxonomy | Addiction Medicine (Anesthesiology) Physician |
| License Number | 01048881A |
| License Number State | IN |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LH0002X |
| Taxonomy | Hospice and Palliative Medicine (Anesthesiology) Physician |
| License Number | 01048881A |
| License Number State | IN |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP3000X |
| Taxonomy | Pediatric Anesthesiology Physician |
| License Number | 01048881A |
| License Number State | IN |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | 01048881A |
| License Number State | IN |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | 01048881A |
| License Number State | IN |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | C55647 |
| License Number State | CA |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LA0401X |
| Taxonomy | Addiction Medicine (Anesthesiology) Physician |
| License Number | C55647 |
| License Number State | CA |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP3000X |
| Taxonomy | Pediatric Anesthesiology Physician |
| License Number | C55647 |
| License Number State | CA |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | C55647 |
| License Number State | CA |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | C55647 |
| License Number State | CA |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LH0002X |
| Taxonomy | Hospice and Palliative Medicine (Anesthesiology) Physician |
| License Number | C55647 |
| License Number State | CA |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | C55647 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: