Most Relevant Information
Provider Data
| NPI Number: | 1003026501 |
| Provider Name: | MOHANNAD MOALLEM M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 2080N0001X |
| Specialty: | Pediatrics |
| License Number: | 01086945A |
Most Important Dates
| Enumeration Date: | 05/23/2007 |
| Last Updated: | 03/28/2022 |
Provider Practice Location
705 RILEY HOSPITAL DR
INDIANAPOLIS
IN
462025109
Practice Location Phone/Fax
| Phone: | 3172744779 |
| Fax: | 3179489806 |
Provider Mailing Location
PO BOX 1026
INDIANAPOLIS
IN
462061026
Provider Mailing Phone/Fax
| Phone: | 3177776435 |
| Fax: | 3177776644 |