Provider Demographics
NPI:1649529462
Name:CENTRAL INDIANA PULMONARY CONSULTANTS, LLC
Entity type:Organization
Organization Name:CENTRAL INDIANA PULMONARY CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABBOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:KAWAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-887-7588
Mailing Address - Street 1:1350 E COUNTY LINE RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-0873
Mailing Address - Country:US
Mailing Address - Phone:317-887-7588
Mailing Address - Fax:317-887-7585
Practice Address - Street 1:1350 E COUNTY LINE RD
Practice Address - Street 2:SUITE H
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-0873
Practice Address - Country:US
Practice Address - Phone:317-887-7588
Practice Address - Fax:317-887-7585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-07
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01052617A207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty