Bourgi, Kassem
Bourgi, Kassem is an individual health care provider with primary practice located at 720 Eskenazi Ave , Indianapolis IN 46202-5187. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Infectious Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Bourgi, Kassem can be contacted via phone (317) 962-0953.Contact Information
Primary practice address
720 Eskenazi Ave
Indianapolis IN 46202-5187
Phone: (317) 962-0953
Fax: (317) 274-1587
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 01080959A | Indiana |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 4301100453 | Michigan |
Profile Details
| NPI number | 1780948299 |
|---|---|
| LBN Legal business name | Bourgi, Kassem |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2012 |
| Last updated | Feb 20th, 2024 - about 10 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780948299 | NPPES |
| Indiana | Other | 264910199 | MEDICARE PTAN |
| Indiana | MEDICAID | 300017285 | MEDICARE PTAN |
| Indiana | Other | 068010534 | MEDICARE PTAN |
| Indiana | Other | Q00008371 | MEDICARE PTAN |
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