Healthcare Provider Details

I. General information

NPI: 1457512816
Provider Name (Legal Business Name): BILAL HAKAM SAFADI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 04/25/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8909 BROADWAY
MERRILLVILLE IN
46410-7039
US

IV. Provider business mailing address

8909 BROADWAY
MERRILLVILLE IN
46410-7039
US

V. Phone/Fax

Practice location:
  • Phone: 219-769-0054
  • Fax:
Mailing address:
  • Phone: 219-769-0054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number01066976A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number036135252
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number01066976A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: