Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 01043330 | IN |
NPI | 1154313260 |
---|---|
Provider Name | Elsayed M. Aly |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46219-1707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 19/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200121150 | (05) | IN |
G12538 | (02) |