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NPI Code Detail

MEDICARE: BASSEL EID M.D.

MEDICARE: BASSEL EID M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistIA

General Provider Information

NPI Number : 1134366909
Entity Type Code : Individual
Provider Name (Legal Business Name) : BASSEL EID M.D.
Provider Business Mailing Address
First Line : 1201 3RD AVE SE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52403-4009
Country : US
Telephone Number : 832-495-3968
Fax Number :
Provider Business Practice Location Address
First Line : 1201 3RD AVE SE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52403-4009
Country : US
Telephone Number : 832-495-3968
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2009
Last Update Date : 10/04/2010

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