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General NPI Number Information
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NPI Number | 1437342987
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Entity Type | Individual
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Provider Name | HUSSAM BITAR M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/18/2007
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Last Update Date | 04/11/2014
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Provider Practice Location Address
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Address Line | 104 BORDERS WAY SUITE 400
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City | WARNER ROBINS
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State | GA
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Zip | 31088-8966
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Country | US
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Telephone | 478-333-2622
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Fax | 478-333-3682
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Provider Business Mailing Address
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Address Line | 104 BORDERS WAY SUITE 400
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City | WARNER ROBINS
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State | GA
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Zip | 31088-8966
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Country | US
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Telephone | 478-333-2622
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Fax | 478-333-3682
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MT-184-844
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 069282
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License Number State | GA
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