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Individual

DR. BASSAM TOME

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1277 WELLBROOK CIR NE, SUITE C, CONYERS, GA 30012-3873
(770) 922-6669
(770) 922-2412
Mailing address
1277 WELLBROOK CIR NE, SUITE C, CONYERS, GA 30012-3873
(770) 922-6669
(770) 922-2412

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
030911
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000412937B
GA
01
52022872001
BLUE CROSS BLUE SHIELD
GA
Enumeration date
12/28/2006
Last updated
12/09/2019
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