Provider Demographics
NPI:1548405285
Name:DAOUD, JACQUES RAYMOND (MD)
Entity Type:Individual
Prefix:DR
First Name:JACQUES
Middle Name:RAYMOND
Last Name:DAOUD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9011 N MERIDIAN ST
Mailing Address - Street 2:SUITE 225
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5378
Mailing Address - Country:US
Mailing Address - Phone:317-574-4747
Mailing Address - Fax:317-574-4737
Practice Address - Street 1:960 CHESTER BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-2317
Practice Address - Country:US
Practice Address - Phone:765-962-4735
Practice Address - Fax:765-939-0035
Is Sole Proprietor?:No
Enumeration Date:2008-12-10
Last Update Date:2024-03-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01067896A207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201064780Medicaid
INM400069686Medicare PIN