Provider Demographics
NPI:1700110822
Name:KARA, FIRAS M (MD)
Entity Type:Individual
Prefix:DR
First Name:FIRAS
Middle Name:M
Last Name:KARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10214 CHESTNUT PLAZA DR PMB 228
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46814-8970
Mailing Address - Country:US
Mailing Address - Phone:260-444-8999
Mailing Address - Fax:260-353-1447
Practice Address - Street 1:7233 W JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-6279
Practice Address - Country:US
Practice Address - Phone:260-353-1444
Practice Address - Fax:260-353-1447
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-22
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY698511379172A00000X
IL130000832207R00000X
MA242129207R00000X
MI4301104116207R00000X
OH35.121160207R00000X
IN01071713A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No172A00000XOther Service ProvidersDriver
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201111960Medicaid
OH0082501Medicaid
INP01438933Medicare PIN
OH0082501Medicaid