Healthcare Provider Details

I. General information

NPI: 1548483225
Provider Name (Legal Business Name): ADEL BENJAMIN SOLIMAN PTD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 KINGS COVE CT
INDIANAPOLIS IN
46260-1605
US

IV. Provider business mailing address

1230 KINGS COVE CT
INDIANAPOLIS IN
46260-1605
US

V. Phone/Fax

Practice location:
  • Phone: 317-413-6279
  • Fax: 317-818-0975
Mailing address:
  • Phone: 317-413-6279
  • Fax: 317-818-0975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number05003927A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: