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Individual

ADAM KYLE HASTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5001 US HIGHWAY 30 W STE D, FORT WAYNE, IN 46818-9701
(260) 432-1568
(260) 432-4969
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01072638A
IN
2085R0202X
Diagnostic Radiology Physician
17471
NH
2085R0202X
Diagnostic Radiology Physician
MD20961
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0169361
OH
05
1518286517
MI
05
201106060
IN
Enumeration date
05/31/2010
Last updated
02/01/2021
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