Healthcare Provider Details

I. General information

NPI: 1578070256
Provider Name (Legal Business Name): BASEEM DAOUD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2018
Last Update Date: 01/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KING FAHAD MEDICAL CITY
RIYADH CENTRAL
11525
SA

IV. Provider business mailing address

1381 LANDER LN
LAFAYETTE CO
80026-8010
US

V. Phone/Fax

Practice location:
  • Phone: 55-336-0905
  • Fax:
Mailing address:
  • Phone: 720-534-0792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number14031
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: