Individual
DR. HUSAM BAKDASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3535 N WEBB RD, WICHITA, KS 67226-8127
(316) 686-5300
(316) 651-2660
Mailing address
3535 N WEBB RD, WICHITA, KS 67226-8127
(316) 686-5300
(316) 651-2660
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-30800
KS
207RC0000X
Cardiovascular Disease Physician
Primary
04-30800
KS
207UN0901X
Nuclear Cardiology Physician
04-30800
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016883002
BLUE CROSS BLUE SHIELD
KS
05
—
200268820L
—
KS
05
—
200268820R
—
KS
05
—
20037310A
—
OK
01
—
KA3651013
MEDICARE
KS
01
—
P00163976
RRMC
KS
Enumeration date
04/28/2006
Last updated
01/31/2019
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