Provider Demographics
NPI:1871122390
Name:ARIDI, HANAA (MD, MS)
Entity type:Individual
Prefix:DR
First Name:HANAA
Middle Name:
Last Name:ARIDI
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:
Other - First Name:HANAA
Other - Middle Name:N
Other - Last Name:DAKOUR ARIDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MS
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1801 N SENATE BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1228
Practice Address - Country:US
Practice Address - Phone:317-274-7827
Practice Address - Fax:317-962-0289
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IN01089606A2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300039129Medicaid
IN233690185OtherMEDICARE PTAN