Individual
HOUSAM ALDEEN SARAKBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 E CHESTNUT ST UNIT 550, LOUISVILLE, KY 40202-5705
(502) 992-7620
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 992-7620
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301113943
MI
207RR0500X
Rheumatology Physician
40639-020
WI
207RR0500X
Rheumatology Physician
4301113943
MI
207RR0500X
Rheumatology Physician
Primary
TP167
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629475066
BCBSWI
WI
05
—
1629475066
—
WI
01
—
SARAKHOU
MERCYCARE INSURANCE
WI
Enumeration date
12/01/2014
Last updated
05/08/2024
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