Provider Demographics
NPI:1336022474
Name:MERZOUG, AADAM ISMAIL
Entity type:Individual
Prefix:
First Name:AADAM
Middle Name:ISMAIL
Last Name:MERZOUG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5995 PEBBLESTREAM DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-8266
Mailing Address - Country:US
Mailing Address - Phone:317-550-9278
Mailing Address - Fax:
Practice Address - Street 1:5995 PEBBLESTREAM DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-8266
Practice Address - Country:US
Practice Address - Phone:317-210-4991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN5270443775172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty