MEDICARE: BASSAM S AL-OWIR MD

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
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	10605	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821046400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BASSAM S AL-OWIR MD

Provider Business Mailing Address
First Line	:	715 MALL RING CIR STE 202
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-6667
Country	:	US
Telephone Number	:	702-483-5092
Fax Number	:	702-483-6202

Provider Business Practice Location Address
First Line	:	715 MALL RING CIR STE 202
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-6667
Country	:	US
Telephone Number	:	702-483-5092
Fax Number	:	702-483-6202

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	06/21/2022

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