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NPI Code Detail

MEDICARE: AGAM ENTERPRISES

MEDICARE: AGAM ENTERPRISES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician01056877AIN

General Provider Information

NPI Number : 1083898993
Entity Type Code : Organization
Provider Name (Legal Business Name) : AGAM ENTERPRISES
Provider Business Mailing Address
First Line : PO BOX 2064
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46206-2064
Country : US
Telephone Number : 812-234-8261
Fax Number : 812-234-8262
Provider Business Practice Location Address
First Line : 2723 S 7TH ST
Second Line :
City : TERRE HAUTE
State : IN
Zip : 47802-3584
Country : US
Telephone Number : 812-237-1625
Fax Number : 812-234-8262
Authorized Official
Title or Position : OWNER
Name : AYMAN GHONIEM
Credential : MD
Telephone Number : 812-320-7229
Provider Enumeration Date : 12/27/2007
Last Update Date : 12/27/2007

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Directions to “AGAM ENTERPRISES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.