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General NPI Number Information
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NPI Number | 1073953006
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Entity Type | Individual
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Provider Name | THAMER ROBERT QAQISH MD
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Gender | Male
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Dates
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Enumeration Date | 07/05/2013
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 462 GRIDER ST
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City | BUFFALO
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State | NY
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Zip | 14215-3098
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Country | US
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Telephone | 716-898-3948
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Fax | 716-961-6969
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Provider Business Mailing Address
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Address Line | 462 GRIDER ST
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City | BUFFALO
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State | NY
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Zip | 14215-3098
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Country | US
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Telephone | 716-898-3948
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Fax | 716-961-6969
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 309863
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | P28805
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License Number State | MD
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