Healthcare Provider Details

I. General information

NPI: 1821624321
Provider Name (Legal Business Name): JUDY HAMAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2020
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W 11TH ST RM 4010
INDIANAPOLIS IN
46202-4108
US

IV. Provider business mailing address

350 W 11TH ST RM 4010
INDIANAPOLIS IN
46202-4108
US

V. Phone/Fax

Practice location:
  • Phone: 317-274-1618
  • Fax:
Mailing address:
  • Phone: 317-274-1618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number4301517686
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number4301517686
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: