Provider Demographics
NPI:1811052517
Name:TADROS, MAGEED (PT,OCS,CWS)
Entity type:Individual
Prefix:MR
First Name:MAGEED
Middle Name:
Last Name:TADROS
Suffix:
Gender:M
Credentials:PT,OCS,CWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7608 HARBOUR ISLE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-3467
Mailing Address - Country:US
Mailing Address - Phone:317-466-1484
Mailing Address - Fax:
Practice Address - Street 1:7608 HARBOUR ISLE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-3467
Practice Address - Country:US
Practice Address - Phone:317-466-1484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05005636A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist