Provider Demographics
NPI:1215932819
Name:KARAKASH, BASHAR (MD)
Entity type:Individual
Prefix:DR
First Name:BASHAR
Middle Name:
Last Name:KARAKASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH STREET
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7250 CLEARVISTA DR
Practice Address - Street 2:SUITE 120
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-4692
Practice Address - Country:US
Practice Address - Phone:317-621-5676
Practice Address - Fax:317-621-5678
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01061137A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP01214634OtherRR MEDICARE PTAN
INP01214634OtherRR MEDICARE PTAN
IN251320JJJMedicare PIN
IN266180139Medicare PIN