Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | FE60095826 | WA |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 01073013A | IN |
NPI | 1063643757 |
---|---|
Provider Name | Hesham Mahmoud Mohamed Eissa |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2009 |
Last Update Date | 21/06/2017 |