Individual
JAIME R HAJJARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1260 E STATE ROAD 205, COLUMBIA CITY, IN 46725
(260) 248-9000
(260) 482-4442
Mailing address
3640 NEW VISION DR STE A, FORT WAYNE, IN 46845-1717
(260) 482-4440
(260) 482-4442
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01078402A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001082449
ANTHEM
—
05
—
300001694
—
IN
Enumeration date
06/24/2014
Last updated
08/15/2018
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