Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 62926 | AZ |
N | 207R00000X | Internist | 62926 | AZ |
N | 111NI0900X | Internist | 62926 | AZ |
N | 207RN0300X | Nephrologist | 35-096659 | OH |
NPI | 1669683470 |
---|---|
Provider Name | Bassam G. Abu Jawdeh |
First Address | Scottsdale, AZ 85259-5452 |
Second Address | Scottsdale, AZ 85259-5452 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 20/05/2021 |