Agam Enterprises, LLC

Organization Active NPI Diagnostic Radiology Physician · Terre Haute, IN

NPI 1386818508 · NPPES record last updated Jul 15, 2008

Key facts

NPI
1386818508
Entity type
Organization (NPI type 2)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
License
01056877A (IN)
Legal business name
AGAM ENTERPRISES, LLC
Practice address
938 Springdale LN
Terre Haute, IN 47802-4586
Phone
(812) 234-8261
Fax
(812) 234-8262
NPI assigned
Apr 18, 2008
Organization subpart
No

Authorized official

Name
Ayman Ghoniem, MD
Title
Owner
Phone
(812) 234-8261

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Agam Enterprises (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
2085R0202X 01056877A IN Yes

Addresses

Primary practice location

938 Springdale LN
Terre Haute, IN 47802-4586

Mailing address

PO Box 2064
Indianapolis, IN 46206-2064
Phone (812) 234-8261

Other identifiers

IdentifierTypeStateIssuer
200882990AMedicaidIN

Other providers in Terre Haute, IN

All providers in Terre Haute, IN · Diagnostic Radiology Physician in Indiana

Sources for this page

Verify at the official NPI Registry.