Provider Demographics
NPI:1194329649
Name:BARKAT-MASIH, AJAY
Entity type:Individual
Prefix:
First Name:AJAY
Middle Name:
Last Name:BARKAT-MASIH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 N HIGH SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46224-2051
Mailing Address - Country:US
Mailing Address - Phone:317-293-1223
Mailing Address - Fax:317-293-7127
Practice Address - Street 1:3350 N HIGH SCHOOL RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-2051
Practice Address - Country:US
Practice Address - Phone:317-293-1223
Practice Address - Fax:317-293-7127
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26017897A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist