=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972698413
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BEHZAD AALAEI M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2006
-----------------------------------------------------
Last Update Date | 10/29/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3741 45TH ST
-----------------------------------------------------
City | HIGHLAND
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46322-3008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 219-924-7246
-----------------------------------------------------
Fax | 219-924-7247
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3741 45TH ST
-----------------------------------------------------
City | HIGHLAND
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46322-3008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 219-924-7246
-----------------------------------------------------
Fax | 219-924-7247
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207LP2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number | 01048881A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | 01048881A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207LA0401X
-----------------------------------------------------
Taxonomy Name | Addiction Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number | 01048881A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 207LH0002X
-----------------------------------------------------
Taxonomy Name | Hospice and Palliative Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number | 01048881A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 207LP3000X
-----------------------------------------------------
Taxonomy Name | Pediatric Anesthesiology Physician
-----------------------------------------------------
License Number | 01048881A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
Taxonomy Code | 208VP0014X
-----------------------------------------------------
Taxonomy Name | Interventional Pain Medicine Physician
-----------------------------------------------------
License Number | 01048881A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
Taxonomy Code | 208VP0000X
-----------------------------------------------------
Taxonomy Name | Pain Medicine Physician
-----------------------------------------------------
License Number | 01048881A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #8
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | C55647
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #9
-----------------------------------------------------
Taxonomy Code | 207LA0401X
-----------------------------------------------------
Taxonomy Name | Addiction Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number | C55647
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #10
-----------------------------------------------------
Taxonomy Code | 207LP3000X
-----------------------------------------------------
Taxonomy Name | Pediatric Anesthesiology Physician
-----------------------------------------------------
License Number | C55647
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #11
-----------------------------------------------------
Taxonomy Code | 208VP0014X
-----------------------------------------------------
Taxonomy Name | Interventional Pain Medicine Physician
-----------------------------------------------------
License Number | C55647
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #12
-----------------------------------------------------
Taxonomy Code | 208VP0000X
-----------------------------------------------------
Taxonomy Name | Pain Medicine Physician
-----------------------------------------------------
License Number | C55647
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #13
-----------------------------------------------------
Taxonomy Code | 207LH0002X
-----------------------------------------------------
Taxonomy Name | Hospice and Palliative Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number | C55647
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #14
-----------------------------------------------------
Taxonomy Code | 207LP2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number | C55647
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------