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General NPI Number Information
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NPI Number | 1013115039
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Entity Type | Individual
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Provider Name | WASSIM SHWAIKI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 8840 CALUMET AVE STE 203
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City | MUNSTER
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State | IN
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Zip | 46321-2546
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Country | US
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Telephone | 219-836-7723
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Fax | 219-836-7726
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Provider Business Mailing Address
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Address Line | PO BOX 1103
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City | CROWN POINT
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State | IN
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Zip | 46308-1103
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Country | US
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Telephone | 219-662-3931
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Fax | 219-663-6359
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 01064103A
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License Number State | IN
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