Provider Demographics
NPI:1780667428
Name:HAMZEH, HALAH (MD)
Entity Type:Individual
Prefix:DR
First Name:HALAH
Middle Name:
Last Name:HAMZEH
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:PO BOX 10518
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46411-0518
Mailing Address - Country:US
Mailing Address - Phone:219-662-3931
Mailing Address - Fax:219-663-6359
Practice Address - Street 1:99 E 86TH AVE STE D
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6267
Practice Address - Country:US
Practice Address - Phone:219-736-9690
Practice Address - Fax:219-736-9691
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059516A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01059516BOtherCSR
IN200804350AMedicaid
IN01059516AOtherSTATE