Provider Demographics
NPI:1912099664
Name:DAJANI, HATEM MARWAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HATEM
Middle Name:MARWAN
Last Name:DAJANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8558 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7032
Mailing Address - Country:US
Mailing Address - Phone:608-630-2291
Mailing Address - Fax:219-703-6854
Practice Address - Street 1:901 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2901
Practice Address - Country:US
Practice Address - Phone:219-836-1600
Practice Address - Fax:219-853-4631
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01066598A208M00000X, 207R00000X
IL036-151982208M00000X
WI49693-20208M00000X
IL036151982207R00000X
OH35.091335207R00000X
WI49693-020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300046595Medicaid
WI100010195Medicaid