Physician Compare National (NPI:1265673990)

HEALTHCARE PROVIDER: WISSAM K HOTEIT M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1265673990
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7012063480
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090928000025
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HOTEIT
	Individual professional last name
Provider First Name	WISSAM
	Individual professional first name
Provider Middle Name	K
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1999
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4841 YOSEMITE PKWY
	Group Practice or individual's line 1 address
City	SYLVANIA
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	435604341
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	360068
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PROMEDICA TOLEDO HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y