Provider Demographics
NPI:1447253539
Name:ARIF, ABUZAFAR M (MD)
Entity type:Individual
Prefix:DR
First Name:ABUZAFAR
Middle Name:M
Last Name:ARIF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3245 HEALTH DR STE 100
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-1380
Mailing Address - Country:US
Mailing Address - Phone:574-647-2129
Mailing Address - Fax:574-237-6069
Practice Address - Street 1:500 ARCADE AVE STE 300
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-2486
Practice Address - Country:US
Practice Address - Phone:574-389-7362
Practice Address - Fax:574-389-5612
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01056480A207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200390270Medicaid
IN236040273OtherMEDICARE PTAN
IN200390270AMedicaid