Provider Demographics
NPI:1053771972
Name:EMAMI GHAFARI, IMAN (DC)
Entity type:Individual
Prefix:MR
First Name:IMAN
Middle Name:
Last Name:EMAMI GHAFARI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1980 E 116TH ST STE 315
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3517
Mailing Address - Country:US
Mailing Address - Phone:317-975-0136
Mailing Address - Fax:
Practice Address - Street 1:1980 E 116TH ST STE 315
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3517
Practice Address - Country:US
Practice Address - Phone:317-975-0136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-04
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002876A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor