Organization Active NPI

Qualcomp Preferred Medical Consultants.PC

  • Primary Care Clinic/Center
  • Muncie, IN
National Provider Identifier
1124154331
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
01047723A Issued in IN
Legal business name
QUALCOMP PREFERRED MEDICAL CONSULTANTS.PC
Practice address
2401 W University Ave
Muncie, IN 47303-3428
Phone
(765) 747-3111
NPI assigned
Feb 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Wail Bakdash, MD
Title
President
Phone
(765) 208-0823

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 01047723A IN Primary

Addresses

Primary practice location

2401 W University Ave
Muncie, IN 47303-3428

Mailing address

10341 Aurora CT
Fishers, IN 46038-5510
Phone (765) 208-0823

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124154331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10341 AURORA CT",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460385510",
            "telephone_number": "765-208-0823",
            "fax_number": "765-298-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W UNIVERSITY AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473033428",
            "telephone_number": "765-747-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALCOMP PREFERRED MEDICAL CONSULTANTS.PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAKDASH",
        "authorized_official_first_name": "WAIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-208-0823",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IN",
            "license": "01047723A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.