Individual
AHSHEEMA ASMAA BACCHUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
32845 RADIO RD, LEESBURG, FL 34788-3977
(352) 504-3453
(352) 504-3454
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8617
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40881
SC
207Q00000X
Family Medicine Physician
ME159085
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
408810
—
SC
Enumeration date
04/20/2017
Last updated
04/27/2023
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