Provider Demographics
NPI:1710989199
Name:ASHRAF, BULAND IQBAL (MD)
Entity Type:Individual
Prefix:DR
First Name:BULAND
Middle Name:IQBAL
Last Name:ASHRAF
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 1:701 E. COUNTY LINE RD.
Mailing Address - Street 2:STE. 101
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1070
Mailing Address - Country:US
Mailing Address - Phone:317-885-2860
Mailing Address - Fax:317-885-2869
Practice Address - Street 1:701 E. COUNTY LINE RD.
Practice Address - Street 2:STE. 101
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1070
Practice Address - Country:US
Practice Address - Phone:317-885-2860
Practice Address - Fax:317-885-2869
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2022-01-13
Deactivation Date:2005-11-16
Deactivation Code:
Reactivation Date:2006-12-11
Provider Licenses
StateLicense IDTaxonomies
IN01039099A207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100381570Medicaid
IN065940YYYMedicare PIN