Healthcare Provider Details

I. General information

NPI: 1790126241
Provider Name (Legal Business Name): NABEEL HASHEM ISMAEIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2013
Last Update Date: 06/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 KING FAISAL SPECIALIST HOSPITAL AND RESEARCH CENTER AL RAWDAH
JEDDAH MAKKAH
23433
SA

IV. Provider business mailing address

1 KING FAISAL SPECIALIST HOSPITAL AND RESEARCH CENTER AL RAWDAH
JEDDAH MAKKAH
23433
SA

V. Phone/Fax

Practice location:
  • Phone: 96626677777
  • Fax:
Mailing address:
  • Phone: 96626677777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberBP10046296
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: