MEDICARE: ROUA ALMOSAWI

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
1	122300000X	Dentist	2901602737	MI

General Provider Information

NPI Number	:	1619790490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROUA ALMOSAWI

Provider Business Mailing Address
First Line	:	460 N WHITE RIVER PKWY WEST DR APT 424
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-4597
Country	:	US
Telephone Number	:	313-258-8458
Fax Number	:

Provider Business Practice Location Address
First Line	:	460 N WHITE RIVER PKWY WEST DR APT 424
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-4597
Country	:	US
Telephone Number	:	313-258-8458
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2024
Last Update Date	:	03/25/2026

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Directions to “ ROUA ALMOSAWI ” Practice Location

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