Ericsoussi, Bassel
Ericsoussi, Bassel is an sole proprietor health care provider with primary practice located at 761 45Th St Ste 108 , Munster IN 46321-2899. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Ericsoussi, Bassel can be contacted via phone (219) 922-5416.Contact Information
Primary practice address
761 45Th St Ste 108
Munster IN 46321-2899
Phone: (219) 922-5416
Fax: (219) 922-3745
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 01069620A | Indiana |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 01069620A | Indiana |
Profile Details
| NPI number | 1700087632 |
|---|---|
| LBN Legal business name | Ericsoussi, Bassel |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 29th, 2007 |
| Last updated | Jul 5th, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700087632 | NPPES |
| Indiana | MEDICAID | 201063870 |
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