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Individual

SUHAIL I HAQUE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
645 S ROY WILKINS AVE, LOUISVILLE, KY 40203-2072
(502) 561-0520
(502) 561-0521
Mailing address
720 W BROADWAY STE 202, LOUISVILLE, KY 40202-3245
(502) 561-0943
(502) 561-0944

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35219
KY
207LP2900X
Pain Medicine (Anesthesiology) Physician
35219
KY
208VP0000X
Pain Medicine Physician
01047434A
IN
208VP0000X
Pain Medicine Physician
35219
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200329370
IN
05
64037195
KY
Enumeration date
05/11/2006
Last updated
12/13/2024
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