Provider Demographics
NPI:1306850375
Name:BISWAS, HARIDAS (MD)
Entity Type:Individual
Prefix:DR
First Name:HARIDAS
Middle Name:
Last Name:BISWAS
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 1:11201 SANDUSKY ST
Mailing Address - Street 2:101
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551
Mailing Address - Country:US
Mailing Address - Phone:419-874-2263
Mailing Address - Fax:419-874-1879
Practice Address - Street 1:11201 SANDUSKY ST
Practice Address - Street 2:101
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551
Practice Address - Country:US
Practice Address - Phone:419-874-2263
Practice Address - Fax:419-874-1879
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH45032207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0512592Medicaid
OHA80188Medicare UPIN
OHBI0503945Medicare PIN