Healthcare Provider Details

I. General information

NPI: 1750414231
Provider Name (Legal Business Name): PLASTIC SURGERY CENTER OF INDIANA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7552 CHABLIS CIR
INDIANAPOLIS IN
46278-1588
US

IV. Provider business mailing address

7552 CHABLIS CIR
INDIANAPOLIS IN
46278-1588
US

V. Phone/Fax

Practice location:
  • Phone: 317-872-2593
  • Fax: 317-872-3727
Mailing address:
  • Phone: 317-872-2593
  • Fax: 317-872-3727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number01023541
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License Number01023541
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number01023541
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number01023541
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number01023541
License Number StateIN

VIII. Authorized Official

Name: DR. HAROON M. QAZI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 317-872-2593