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General NPI Number Information
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NPI Number | 1043282395
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Entity Type | Individual
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Provider Name | NASSER JAMAL ALQASSEM MD
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Gender | Male
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 05/25/2012
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Provider Practice Location Address
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Address Line | 1101 9TH ST STE A
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City | ALAMOGORDO
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State | NM
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Zip | 88310
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Country | US
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Telephone | 505-437-8411
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Fax | 505-443-1753
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Provider Business Mailing Address
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Address Line | 1101 9TH ST STE A
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City | ALAMOGORDO
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State | NM
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Zip | 88310-6432
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Country | US
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Telephone | 505-437-8411
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Fax | 505-443-1753
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 20020444
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License Number State | NM
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