Provider Demographics
NPI:1841250024
Name:HAQ, NISAR (MD)
Entity type:Individual
Prefix:
First Name:NISAR
Middle Name:
Last Name:HAQ
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 1:6540 WINTON RD
Mailing Address - Street 2:STE G11
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-1391
Mailing Address - Country:US
Mailing Address - Phone:513-981-4180
Mailing Address - Fax:513-853-5600
Practice Address - Street 1:2450 KIPLING AVE
Practice Address - Street 2:STE G11
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-6600
Practice Address - Country:US
Practice Address - Phone:513-981-4180
Practice Address - Fax:513-853-5600
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35072060207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2053110Medicaid
OHHA2020331Medicare PIN
OH2053110Medicaid