NPI Code Details Logo

NPI 1629072111

NPI 1629072111 : BASSAM N HELOU M.D. : INDIANAPOLIS, IN

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1629072111
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    BASSAM N HELOU M.D.
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/13/2005
-----------------------------------------------------
    Last Update Date     |    05/26/2015
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    7120 CLEARVISTA DRIVE SUITE 2100
-----------------------------------------------------
    City                 |    INDIANAPOLIS
-----------------------------------------------------
    State                |    IN
-----------------------------------------------------
    Zip                  |    46256-0020
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    317-621-2740
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    6626 E 75TH ST SUITE 500
-----------------------------------------------------
    City                 |    INDIANAPOLIS
-----------------------------------------------------
    State                |    IN
-----------------------------------------------------
    Zip                  |    46250-2805
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207R00000X
-----------------------------------------------------
    Taxonomy Name        |    Internal Medicine Physician
-----------------------------------------------------
    License Number       |    01039120A
-----------------------------------------------------
    License Number State |    IN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    207RC0200X
-----------------------------------------------------
    Taxonomy Name        |    Critical Care Medicine (Internal Medicine) Physician
-----------------------------------------------------
    License Number       |    01039120A
-----------------------------------------------------
    License Number State |    IN
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.