Basic Information
Provider Information
NPI: 1801233077
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALHAJJAR
FirstName: OSAMA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1206 FOXMOOR RUN
Address2:  
City: FORT WAYNE
State: IN
PostalCode: 468256518
CountryCode: US
TelephoneNumber: 2606159451
FaxNumber:  
Practice Location
Address1: 320 E NORTH AVE
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152124756
CountryCode: US
TelephoneNumber: 4123594971
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/29/2013
LastUpdateDate: 05/29/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMT204520PAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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