MEDICARE: NISAR HAQ MD

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
1	207R00000X	Internal Medicine Physician	35072060	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841250024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NISAR HAQ MD

Provider Business Mailing Address
First Line	:	6540 WINTON RD
Second Line	:	STE G11
City	:	CINCINNATI
State	:	OH
Zip	:	45224-1391
Country	:	US
Telephone Number	:	513-981-4180
Fax Number	:	513-853-5600

Provider Business Practice Location Address
First Line	:	2450 KIPLING AVE
Second Line	:	STE G11
City	:	CINCINNATI
State	:	OH
Zip	:	45239-6600
Country	:	US
Telephone Number	:	513-981-4180
Fax Number	:	513-853-5600

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	06/16/2016

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Directions to “ NISAR HAQ MD” Practice Location

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