Individual
BASSAM A. OMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2451 FILLINGIM ST, BLDG. C, MOBILE, AL 36617-2238
(251) 445-8242
(251) 445-8250
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 445-8242
(251) 445-8250
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
18169
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126751
—
MS
05
—
009908705
—
AL
05
—
009908725
—
AL
05
—
1165891
—
LA
01
—
25-10824
UNITED HEALTH CARE
AL
01
—
51513252
BLUE CROSS
AL
01
—
51513255
BLUE CROSS
AL
Enumeration date
05/23/2006
Last updated
05/12/2015
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