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General NPI Number Information
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NPI Number | 1477841633
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Entity Type | Individual
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Provider Name | AHMED ABUSAMRA
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Gender | Male
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Dates
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Enumeration Date | 07/21/2011
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 1402 E COUNTY LINE RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-0963
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Country | US
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Telephone | 317-887-7957
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Fax |
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Provider Business Mailing Address
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Address Line | 6626 E 75TH ST SUITE 500
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-2805
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Country | US
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Telephone | 317-621-9002
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 01072955A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 4301099117
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 01072955A
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License Number State | IN
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