Roukoz, Bassam A.
Roukoz, Bassam A. is an individual health care provider with primary practice located at 1390 Highway 61 Suite 3300, Festus MO 63028-4137. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Roukoz, Bassam A. can be contacted via phone (636) 931-6302.Contact Information
Primary practice address
1390 Highway 61 Suite 3300
Festus MO 63028-4137
Phone: (636) 931-6302
Fax: (636) 931-3609
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 2003007582 | Missouri |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 190958 | Missouri |
Profile Details
| NPI number | 1396744439 |
|---|---|
| LBN Legal business name | Roukoz, Bassam A. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2005 |
| Last updated | Jun 26th, 2012 - about 13 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 | 1396744439 | NPPES |
| Missouri | MEDICAID | 208766204 | |
| Missouri | MEDICAID | 208766212 |
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