Maryam Jameelah Adisa
Family Medicine in Merrillville, IN. Individual provider (NPI-1).
NPI number1134869522
StatusActive
Last updated in NPPESJul 6, 2026
Details
- NPI
- 1134869522
- Entity type
- Individual (NPI-1)
- Name
- Maryam Jameelah Adisa
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 1, 2022
- Certification date
- Jul 6, 2026
- Last updated
- Jul 6, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 02008985A | IN | Yes |
Practice location
751 E 81st AveMerrillville, IN 46410-5538
Phone 219-791-9389
Mailing address
751 E 81st AveMerrillville, IN 46410-5538
Phone 219-791-9389
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