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Individual

MOHAMMAD HAIDOUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
611 E DOUGLAS RD STE 309, MISHAWAKA, IN 46545-1467
(574) 335-6770
(574) 335-0779
Mailing address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3833

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57.249573
OH
207R00000X
Internal Medicine Physician
A185951
CA
207RI0200X
Infectious Disease Physician
Primary
01096548A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300114662
IN
Enumeration date
07/29/2020
Last updated
09/11/2025
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