Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 02005113A | IN |
N | 207V00000X | Obstetrician & Gynecologist | 036-094459 | IL |
NPI | 1023004504 |
---|---|
Provider Name | Nizar Olabi |
First Address | Lebanon, IN 46052-8622 |
Second Address | Lebanon, IN 46052-8628 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 15/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
300011045 | (05) | IN |
G56799 | (02) |