Khasawneh, Wasim A

Khasawneh, Wasim A is an individual health care provider with primary practice located at 2600 Greenbush St , Lafayette IN 47904-2477. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine. Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine is his primary health care specialty. Khasawneh, Wasim A can be contacted via phone (765) 448-8000.

Contact Information

Primary practice address
2600 Greenbush St Lafayette IN 47904-2477
Phone: (765) 448-8000
Fax: (765) 488-8564
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35.098001 Ohio
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 01075923A Indiana
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 01075923A Indiana
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 57012659 Ohio

Profile Details

NPI number 1508054446
LBN Legal business name Khasawneh, Wasim A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2007
Last updated Jul 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508054446 NPPES
Indiana Other 000000964894 ANTHEM PROVIDER NUMBER
Indiana MEDICAID 201320950 ANTHEM PROVIDER NUMBER

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