Provider Demographics
NPI:1427167584
Name:KADAH, HAYSSAM (MD)
Entity type:Individual
Prefix:DR
First Name:HAYSSAM
Middle Name:
Last Name:KADAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9330 SOUTH BROADWAY
Mailing Address - Street 2:ABJ VA OUTPATIENT CLINIC
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307
Mailing Address - Country:US
Mailing Address - Phone:219-662-5050
Mailing Address - Fax:
Practice Address - Street 1:9330 BROADWAY
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-8602
Practice Address - Country:US
Practice Address - Phone:219-662-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039940A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine