Individual
HISHAM IBRAHIM BASSIOUNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
5046 HIGHWAY 17 BYP S STE 103, MYRTLE BEACH, SC 29588-4503
(843) 668-4104
Mailing address
5046 HIGHWAY 17 BYP S STE 103, MYRTLE BEACH, SC 29588-4503
(843) 668-4104
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50001725
OH
363A00000X
Physician Assistant
Primary
PA3422
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00385946
RR ERIE
—
Enumeration date
05/27/2006
Last updated
04/08/2025
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