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1881654523
HAROLD MUSTAPHA BACCHUS
FORT WAYNE, IN
NPI
1881654523
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IN 01034833)
Enumeration Date
2006-03-25
Last Update Date
2009-12-20
Business Address
Dr. HAROLD MUSTAPHA BACCHUS MD
1719 CREMER AVE
FORT WAYNE, IN 46818-1052
Phone number: 260-490-9150
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Mailing Address
Dr. HAROLD MUSTAPHA BACCHUS MD
12002 WOODBOURNE CT
FT WAYNE, IN 46845-1952
Phone number: 260-637-5303
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