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NPI Code Detail

MEDICARE: HOSSAM FATHI HALAWEISH

MEDICARE: HOSSAM FATHI HALAWEISH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician125.088413IL
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1780481234
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOSSAM FATHI HALAWEISH
Provider Business Mailing Address
First Line : 8057 GARFIELD ST NE
Second Line :
City : SPRING LAKE PARK
State : MN
Zip : 55432-2164
Country : US
Telephone Number : 605-633-8176
Fax Number :
Provider Business Practice Location Address
First Line : 420 DELAWARE ST SE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55455-0341
Country : US
Telephone Number : 612-626-2935
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2025
Last Update Date : 06/23/2026

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Directions to “ HOSSAM FATHI HALAWEISH ” Practice Location

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