Healthcare Provider Details

I. General information

NPI: 1376512376
Provider Name (Legal Business Name): RABAB FATIMA HASHIM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 12/14/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 HENRY ST
NORTH VERNON IN
47265-1030
US

IV. Provider business mailing address

10330 N MERIDIAN ST SUITE 201
CARMEL IN
46290-1024
US

V. Phone/Fax

Practice location:
  • Phone: 812-352-4460
  • Fax: 812-352-4419
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number01057923A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number01057923A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: