Provider Demographics
NPI:1649565367
Name:HAQUE, UNEEZA K (MD)
Entity Type:Individual
Prefix:MS
First Name:UNEEZA
Middle Name:K
Last Name:HAQUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2037 WALES AVE NW STE 130
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-4185
Mailing Address - Country:US
Mailing Address - Phone:330-830-9378
Mailing Address - Fax:330-830-1534
Practice Address - Street 1:2037 WALES AVE NW STE 130
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-4185
Practice Address - Country:US
Practice Address - Phone:330-830-9378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.147381207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine