Individual
HAITAM MOHAMAD BUAISHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11104 PARKVIEW CIRCLE DR STE 310, FORT WAYNE, IN 46845-1733
(260) 266-5230
(260) 458-5972
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
7174
NE
207RG0100X
Gastroenterology Physician
Primary
01096804A
IN
207RG0100X
Gastroenterology Physician
32530
NE
207RG0100X
Gastroenterology Physician
33345
WV
Other
Enumeration date
08/13/2014
Last updated
09/02/2025
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