Bassam G. Wanna
Internist Internist - Cardiovascular Disease Clinical Cardiac Electrophysiologist
64040 Highway 434 Suite 200
Lacombe
, Louisiana 70445-3499
Bassam G. Wanna
Internist Internist - Cardiovascular Disease Clinical Cardiac Electrophysiologist
64040 Highway 434 Suite 200
Lacombe
, Louisiana 70445-3499
(985) 892-8916
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About
Features
Specialties
- Internist
- Internist - Cardiovascular Disease
- Clinical Cardiac Electrophysiologist
Languages spoken
- English
Location
First Address
- Bassam G. Wanna
- 64040 Highway 434 Suite 200
- Lacombe, LA
- Zip : 70445-3499
- Fax : (985) 892-8916
- Phone : (985) 892-9233
Second Address
- Bassam G. Wanna
- 64040 Highway 434 Suite 200
- Lacombe, LA
- Zip : 70445-3499
- Fax : (985) 892-8916
- Phone : (985) 892-9233
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207R00000X | Internist | MD.204036 | LA |
| N | 111NI0900X | Internist | MD.204036 | LA |
| N | 207RC0000X | Internist - Cardiovascular Disease | MD.204036 | LA |
| Y | 207RC0001X | Clinical Cardiac Electrophysiologist | MD.204036 | LA |
National Provider Identifier
| NPI | 1265638639 |
|---|---|
| Provider Name | Bassam G. Wanna |
| First Address | Lacombe, LA 70445-3499 |
| Second Address | Lacombe, LA 70445-3499 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/06/2007 |
| Last Update Date | 03/04/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 275915YJC4 | GROUP MEMBER PTAN (01) | LA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.