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Individual

SIMON JESUS KASSIS HADID

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
16000 JOHNSTON MEMORIAL DR FL 4, ABINGDON, VA 24211-7664
(276) 258-1000
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101277821
VA
207R00000X
Internal Medicine Physician
ME107402
FL
208M00000X
Hospitalist Physician
Primary
0101277821
VA
390200000X
Student in an Organized Health Care Education/Training Program
11608
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
149P3
BC/BS
FL
01
DP021Z
MEDICARE PTAN
FL
Enumeration date
09/26/2008
Last updated
03/26/2024
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