Healthcare Provider Details

I. General information

NPI: 1679500862
Provider Name (Legal Business Name): HUSSAM SALAHEDDIN ABUISSA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 03/02/2021
Certification Date: 03/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 MERCY RD
OMAHA NE
68124-2319
US

IV. Provider business mailing address

7500 MERCY RD
OMAHA NE
68124-2319
US

V. Phone/Fax

Practice location:
  • Phone: 402-398-5880
  • Fax: 402-398-6716
Mailing address:
  • Phone: 402-398-5880
  • Fax: 402-398-6716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number51026
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD-38612
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number25203
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: