Healthcare Provider Details

I. General information

NPI: 1790918019
Provider Name (Legal Business Name): HASHEM SAMIR ALMARZOUKI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HASHIM SAMIR AL-MARZOUKI MD

II. Dates (important events)

Enumeration Date: 09/02/2009
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OPHTHALMOLOGY DEPARTMENT, MCGILL UNIVERSITY 3655 PROMENADE SIR WILLIAM OSLER
MONTREAL QC
H3G 1Y6
CA

IV. Provider business mailing address

385 E GREEN ST 2513
PASADENA CA
91101-2321
US

V. Phone/Fax

Practice location:
  • Phone: 514-398-3595
  • Fax:
Mailing address:
  • Phone: 514-983-6357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberR11659
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: