Boustani, Malaz A

Boustani, Malaz A is an individual health care provider with primary practice located at 720 Eskenazi Ave Fl 6 , Indianapolis IN 46202-5189. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is his primary health care specialty. Boustani, Malaz A can be contacted via phone (317) 880-6600.

Contact Information

Primary practice address
720 Eskenazi Ave Fl 6 Indianapolis IN 46202-5189
Phone: (317) 880-6600
Fax: (317) 880-0333
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 01055882A Indiana
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 01055882A Indiana

Profile Details

NPI number 1891751079
LBN Legal business name Boustani, Malaz A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Nov 29th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891751079 NPPES
Indiana Other 000000230417 ANTHEM
Indiana MEDICAID 200389990 ANTHEM

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