Provider Demographics
NPI:1437342987
Name:BITAR, HUSSAM (MD)
Entity Type:Individual
Prefix:DR
First Name:HUSSAM
Middle Name:
Last Name:BITAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 BORDERS WAY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-8966
Mailing Address - Country:US
Mailing Address - Phone:478-333-2622
Mailing Address - Fax:478-333-3682
Practice Address - Street 1:104 BORDERS WAY
Practice Address - Street 2:SUITE 400
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-8966
Practice Address - Country:US
Practice Address - Phone:478-333-2622
Practice Address - Fax:478-333-3682
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-18
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT-184-844208600000X
GA069282208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery