Individual
DR. ISAM ANDRAWGS HADDADIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD FACS
Contact information
Practice address
3641 RIDGE RD, HIGHLAND, IN 46322
(219) 923-2100
(219) 923-9342
Mailing address
3641 RIDGE RD, HIGHLAND, IN 46322
(219) 923-2100
(219) 923-9342
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01029890A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100168870A
—
IN
01
—
87493
BLUE CROSS BLUE SHIELD
—
01
—
91108082
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/25/2006
Last updated
04/06/2010
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