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NPI Code Detail

MEDICARE: DR. BASSEM I RAZZOUK MD

MEDICARE: DR. BASSEM I RAZZOUK MD
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
12080P0207XPediatric Hematology & Oncology Physician01063092AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124021829
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BASSEM I RAZZOUK MD
Provider Business Mailing Address
First Line : 10330 N MERIDIAN ST
Second Line : SUITE 201
City : INDIANAPOLIS
State : IN
Zip : 46290-1024
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2001 W 86TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-1902
Country : US
Telephone Number : 317-338-4673
Fax Number : 317-338-3227
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 04/11/2012

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Directions to “ DR. BASSEM I RAZZOUK MD” Practice Location

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