MEDICARE: BASSEM ROUPHAEL 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	207R00000X	Internal Medicine Physician	7123	KS
2	207RN0300X	Nephrology Physician	0437900	KS

General Provider Information

NPI Number	:	1851520381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BASSEM ROUPHAEL MD

Provider Business Mailing Address
First Line	:	1035 N EMPORIA AVE STE 105
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67214-2998
Country	:	US
Telephone Number	:	316-263-7285
Fax Number	:	316-263-2666

Provider Business Practice Location Address
First Line	:	1035 N EMPORIA AVE STE 105
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67214-2998
Country	:	US
Telephone Number	:	316-263-7285
Fax Number	:	316-263-2666

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

Provider Enumeration Date	:	07/06/2009
Last Update Date	:	06/15/2026

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Directions to “ BASSEM ROUPHAEL MD” Practice Location

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