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Individual

FAYSAL MASSARWEH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1 KISH HOSPITAL DR, DEKALB, IL 60115-9602
(815) 756-1521
(815) 748-5789
Mailing address
6435 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6203
(260) 344-4035
(260) 969-9272

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01076145A
IN
207R00000X
Internal Medicine Physician
35.131179
OH
208M00000X
Hospitalist Physician
Primary
036165259
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0179577
OH
05
201355800
IN
Enumeration date
02/04/2016
Last updated
12/18/2023
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