Healthcare Provider Details

I. General information

NPI: 1356359905
Provider Name (Legal Business Name): MAJDI M ABU-SALIH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MAJDI M SALIH

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 11/27/2023
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8040 CLEARVISTA PKWY SUITE 460
INDIANAPOLIS IN
46256-5630
US

IV. Provider business mailing address

6626 E 75TH ST SUITE 500
INDIANAPOLIS IN
46250-2805
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-2660
  • Fax: 317-621-1535
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01069479A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number37692
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number01069479A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: