Basic Information
| Provider Information | |||||||||
| NPI: | 1912214818 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AL-NAJJAR | ||||||||
| FirstName: | AHMAD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6626 E 75TH ST STE 500 | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462502890 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1515 N MADISON AVE | ||||||||
| Address2: | |||||||||
| City: | ANDERSON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 46011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7652984242 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2010 | ||||||||
| LastUpdateDate: | 09/04/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD-40722 | IA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 40722 | IA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | MD-40722 | IA | N | Allopathic & Osteopathic Physicians | Hospitalist | 390200000X | 4301097309 | MI | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 01082828A | IN | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 300029914 | 05 | IN | MEDICAID |