Provider Demographics
NPI:1164598504
Name:KHOLOKI, AKRAM (MD)
Entity Type:Individual
Prefix:DR
First Name:AKRAM
Middle Name:
Last Name:KHOLOKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 SAINT MARY RD STE 202
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-3986
Mailing Address - Country:US
Mailing Address - Phone:219-286-3788
Mailing Address - Fax:219-286-3791
Practice Address - Street 1:3800 SAINT MARY RD STE 202
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3986
Practice Address - Country:US
Practice Address - Phone:219-286-3788
Practice Address - Fax:219-286-3791
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01046098A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
90000561OtherBLUE SHIELD OF IL
060044331OtherRAILROAD MEDICARE
000000180622OtherBLUE CROSS BLUE SHIELD IN
IN200139560Medicaid