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General NPI Number Information
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NPI Number | 1407218621
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Entity Type | Individual
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Provider Name | HADI ATASSI D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/26/2016
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 9030 COLUMBIA AVE STE B
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City | MUNSTER
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State | IN
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Zip | 46321-2905
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Country | US
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Telephone | 219-836-6002
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Fax | 219-836-6003
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Provider Business Mailing Address
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Address Line | 9030 COLUMBIA AVE STE B
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City | MUNSTER
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State | IN
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Zip | 46321-2905
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Country | US
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Telephone |
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Fax |
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 02007039A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 04701
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License Number State | KY
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