Khadra, Imad E.
Khadra, Imad E. is an individual health care provider with primary practice located at 3920 St Francis Way Ste 220 , Lafayette IN 47905. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Khadra, Imad E. can be contacted via phone (765) 502-4110.Contact Information
Primary practice address
3920 St Francis Way Ste 220
Lafayette IN 47905
Phone: (765) 502-4110
Fax: (765) 428-5951
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 01036728 | Indiana |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 01036728 | Indiana |
Profile Details
| NPI number | 1205855418 |
|---|---|
| LBN Legal business name | Khadra, Imad E. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 19th, 2006 |
| Last updated | May 8th, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205855418 | NPPES |
| Indiana | MEDICAID | 100087520 | |
| Indiana | Other | M400062471 |
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