Individual
DR. BASSEM SROUR
Active
Individual
DR. BASSEM SROUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036117729
IL
207RP1001X
Pulmonary Disease Physician
Primary
01075048A
IN
207RS0012X
Sleep Medicine (Internal Medicine) Physician
01075048A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201288330
—
IN
01
—
217960001
MEDICARE PTAN
IN
01
—
P01518955
MEDICARE RR PTAN
IN
Enumeration date
07/08/2007
Last updated
07/21/2022
Update your record
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