Provider Demographics
NPI:1346831823
Name:MUDHAR, LUVLEEN (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:LUVLEEN
Middle Name:
Last Name:MUDHAR
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 W 56TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-1507
Mailing Address - Country:US
Mailing Address - Phone:317-251-9518
Mailing Address - Fax:317-251-8472
Practice Address - Street 1:119 W 56TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-1507
Practice Address - Country:US
Practice Address - Phone:317-251-9518
Practice Address - Fax:317-251-8472
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26024616A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist