Baroudi, Bassam
Baroudi, Bassam is an sole proprietor health care provider with primary practice located at 4215 15Th St , Gulfport MS 39501-2523. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Baroudi, Bassam can be contacted via phone (228) 863-5211.Contact Information
Primary practice address
4215 15Th St
Gulfport MS 39501-2523
Phone: (228) 863-5211
Fax: (228) 863-4101
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 15167 | Mississippi |
Profile Details
| NPI number | 1487683231 |
|---|---|
| LBN Legal business name | Baroudi, Bassam |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 2nd, 2006 |
| Last updated | Oct 19th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487683231 | NPPES |
| Mississippi | MEDICAID | 00120353 |
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