Provider Demographics
NPI:1376750745
Name:ABURAJAB, MURAD ADNAN (MD)
Entity Type:Individual
Prefix:
First Name:MURAD
Middle Name:ADNAN
Last Name:ABURAJAB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MURAD
Other - Middle Name:ADNAN
Other - Last Name:ABU RAJAB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:13450 N MERIDIAN ST STE 354
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1486
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13450 N MERIDIAN ST STE 354
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1486
Practice Address - Country:US
Practice Address - Phone:317-582-8931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA225179207R00000X
IN01079804A207R00000X, 207RG0100X
IA37713207R00000X
WI62617207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1376750745Medicaid
IAI0923060Medicare PIN
IAP00608394Medicare PIN
WIK400163669Medicare PIN