Provider Demographics
NPI:1881191096
Name:RANGOONWALA, HUSSAIN ISMAIL (MBBS)
Entity Type:Individual
Prefix:DR
First Name:HUSSAIN
Middle Name:ISMAIL
Last Name:RANGOONWALA
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8326 NAAB RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1920
Mailing Address - Country:US
Mailing Address - Phone:317-871-0011
Mailing Address - Fax:317-870-4552
Practice Address - Street 1:8326 NAAB RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1920
Practice Address - Country:US
Practice Address - Phone:317-871-0011
Practice Address - Fax:317-870-4552
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01085978A207RH0002X, 207R00000X
NE390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program