Healthy Aging Enterprise, LLC

NPI #1417315102 in Fishers, Indiana

Provider Information

NPI Number: 1417315102
Entity Type: Organization
Organization Name: Healthy Aging Enterprise, LLC
Primary Specialty: Internal Medicine
Enumeration Date: Feb 9, 2016
Last Updated: Feb 9, 2016

Practice Location

Address: 10926 BELLE PLAINE BLVD
City: Fishers
State: Indiana
ZIP Code: 46037-7113
Phone: (317) 985-9501

Authorized Official

Name: DR. MARWAN MUSTAKLEM, M.D.
Title: MBR
Phone: (317) 985-9501

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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