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NPI Code Detail

MEDICARE: MALIK NOURI MD

MEDICARE: MALIK NOURI 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
1207LP3000XPediatric Anesthesiology Physician01052991IN
2207L00000XAnesthesiology Physician01052991IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730161449
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALIK NOURI MD
Provider Business Mailing Address
First Line : 6626 E 75TH ST STE 500
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2890
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1500 N RITTER AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-3027
Country : US
Telephone Number : 317-355-1411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2005
Last Update Date : 12/29/2024

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