Provider Demographics
NPI:1427461268
Name:KOJIMA, ALAN K (MD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:K
Last Name:KOJIMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2901 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-4307
Practice Address - Country:US
Practice Address - Phone:765-286-3900
Practice Address - Fax:765-286-3915
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD60834926207V00000X
AL37361207V00000X
HIMD21658207V00000X
IN01091422A207V00000X
FLTRN20626207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology