Individual
DR. HUSAM BAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1331 STATE ST, LA PORTE, IN 46350-3112
(219) 326-1234
Mailing address
50925 SAFARI DR, GRANGER, IN 46530-6737
(312) 451-4630
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01056375A
IN
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
01056375A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000940640
BCBS
IN
05
—
200383950
—
IN
Enumeration date
11/29/2007
Last updated
10/30/2024
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