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General NPI Number Information
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NPI Number | 1710905666
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Entity Type | Individual
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Provider Name | SUBRIE AHMED ABEDALLHADI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1210 MEDICAL ARTS BLVD # A SUITE 105
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City | ANDERSON
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State | IN
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Zip | 46011-3461
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Country | US
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Telephone | 765-298-4660
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Fax | 765-298-4926
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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 |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 01062234A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 01062234A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 01062234A
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License Number State | IN
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