Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | 22700 | NE |
N | 207RI0011X | Interventional Cardiology | 35638 | IA |
NPI | 1013997741 |
---|---|
Provider Name | Haysam Akkad |
First Address | Omaha, NE 68131-2868 |
Second Address | Omaha, NE 68131-2868 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 30/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0580456 | (05) | IA |
47070592313 | (05) | NE |
G43343 | (02) |