Healthcare Provider Details

I. General information

NPI: 1811157357
Provider Name (Legal Business Name): IBRAR FAQIR PARACHA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2485 DIRECTORS ROW STE D
INDIANAPOLIS IN
46241-4907
US

IV. Provider business mailing address

2485 DIRECTORS ROW STE D
INDIANAPOLIS IN
46241-4907
US

V. Phone/Fax

Practice location:
  • Phone: 317-941-7338
  • Fax: 317-969-6727
Mailing address:
  • Phone: 317-941-7338
  • Fax: 317-969-6727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01068554A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number01068554A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number01068554A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: