Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD-47329 | IA |
N | 2080P0202X | Pediatric Cardiologist | 036138029 | IL |
N | 2080P0202X | Pediatric Cardiologist | 4301114822 | MI |
Y | 2080P0202X | Pediatric Cardiologist | MD-47329 | IA |
NPI | 1083011613 |
---|---|
Provider Name | Bassel Mohammad Nijres |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2014 |
Last Update Date | 27/08/2020 |