Healthcare Provider Details

I. General information

NPI: 1346322393
Provider Name (Legal Business Name): FALEH ATASSI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 LINCOLNWAY
VALPARAISO IN
46383-5804
US

IV. Provider business mailing address

808 E. LINCOLNWAY
VALPARAISO IN
46383-5804
US

V. Phone/Fax

Practice location:
  • Phone: 219-462-4446
  • Fax: 219-464-3831
Mailing address:
  • Phone: 219-462-4446
  • Fax: 219-464-3831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number01044631
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01044631
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: