Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MDFE.FE.61054717 | WA |
NPI | 1033787494 |
---|---|
Provider Name | Mohammed Basamh |
First Address | Seattle, WA 98122-5789 |
Second Address | Seattle, WA 98122-5789 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2021 |
Last Update Date | 14/06/2021 |