Provider Demographics
NPI:1598766321
Name:KABIR, SAIFUL (MD)
Entity Type:Individual
Prefix:
First Name:SAIFUL
Middle Name:
Last Name:KABIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:STE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1210B MEDICAL ARTS BLVD
Practice Address - Street 2:SUITE 214
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-3461
Practice Address - Country:US
Practice Address - Phone:765-298-4300
Practice Address - Fax:765-298-4947
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01038701A174400000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100172660AMedicaid
INP01824514OtherRR PTAN
INP01824514OtherRR PTAN
IN266180922Medicare PIN
INE58265Medicare UPIN