Provider Demographics
NPI:1922326370
Name:NADEEM U KAMRAN,MD, LLC
Entity Type:Organization
Organization Name:NADEEM U KAMRAN,MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NADEEM
Authorized Official - Middle Name:U
Authorized Official - Last Name:KAMRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-575-9037
Mailing Address - Street 1:PO BOX 2322
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46384-2322
Mailing Address - Country:US
Mailing Address - Phone:219-575-9037
Mailing Address - Fax:
Practice Address - Street 1:3141 PEPPER CREEK BRIDGE PKWY
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-7128
Practice Address - Country:US
Practice Address - Phone:219-575-9037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-10
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01048490A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ING-19217Medicare UPIN