Provider Demographics
NPI:1598224594
Name:ASRAR, ASNA (MD)
Entity Type:Individual
Prefix:
First Name:ASNA
Middle Name:
Last Name:ASRAR
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 1:1002 WISHARD BLVD STE 3120
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-4164
Mailing Address - Country:US
Mailing Address - Phone:317-944-4846
Mailing Address - Fax:317-948-0126
Practice Address - Street 1:1002 WISHARD BLVD STE 2120
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-4164
Practice Address - Country:US
Practice Address - Phone:317-944-4846
Practice Address - Fax:317-321-1373
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01088063A2080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300064105Medicaid