Healthcare Provider Details

I. General information

NPI: 1942441357
Provider Name (Legal Business Name): SAHAR BASSAM HACHEM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2009
Last Update Date: 02/08/2022
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8110 E 32ND ST N STE 125
WICHITA KS
67226-2644
US

IV. Provider business mailing address

8110 E 32ND ST N STE 125
WICHITA KS
67226-2644
US

V. Phone/Fax

Practice location:
  • Phone: 316-330-2525
  • Fax: 866-378-4552
Mailing address:
  • Phone: 316-330-3636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number04-33379
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: