Individual
WALID KHABBAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
610 N MICHIGAN ST STE 306, SOUTH BEND, IN 46601-1079
(574) 647-6500
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
01051874A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200262960
—
IN
Enumeration date
09/27/2006
Last updated
05/29/2025
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