Provider Demographics
NPI:1407238330
Name:FAQAH, ANADIL (MD)
Entity Type:Individual
Prefix:MS
First Name:ANADIL
Middle Name:
Last Name:FAQAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 W WALNUT ST # R2202
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5188
Mailing Address - Country:US
Mailing Address - Phone:317-278-6061
Mailing Address - Fax:
Practice Address - Street 1:950 W WALNUT STREET
Practice Address - Street 2:R2 202
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5181
Practice Address - Country:US
Practice Address - Phone:317-278-6061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program