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Individual

HAYTHAM B. BISHARA

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
240 HIGHLAND DR, MANY, LA 71449-3718
(318) 256-5691
Mailing address
PO BOX 1891, MANY, LA 71449-1891
(318) 590-1301

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
13078R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1553573
LA
Enumeration date
05/19/2006
Last updated
07/08/2007
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