Healthcare Provider Details

I. General information

NPI: 1609193564
Provider Name (Legal Business Name): ASAAD A. AL-ASAAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2010
Last Update Date: 04/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RIYADH CARE HOSPITAL - ONAIZA STREET RAWABI
RIYADH CENTRAL
11541
SA

IV. Provider business mailing address

10 HIND BINT OTBA STREET PO BOX 250012
RIYADH CENTRAL
11391
SA

V. Phone/Fax

Practice location:
  • Phone: 966504264695
  • Fax: 96614631411
Mailing address:
  • Phone: 966504264695
  • Fax: 96614631411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number155356
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: