| Doctor Name: | DR. KENNETH K MOGHADAM |
| NPI Number: | 1033120282 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 01051029A |
| Business Practice Address: | 11725 N Illinois St Suite 515 Carmel, IN - 460323008 |
| Business Phone Number: | 3178144110 |
| Business Fax Number: | 3178144114 |
| Mailing Address: | 11725 N Illinois St, Suite 515 CARMEL |
| State: | IN |
| Postal Code: | 460323008 |
| Phone Number: | 3178144110 |
| Fax Number: | 3178144114 |
| NPI Enumeration Date: | 08/11/2006 |
| NPI Last Update Date: | 04/30/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VE0102X |
| License Number: | 01051029A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Reproductive Endocrinology |
| Taxonomy Definition: | An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. |