Provider Demographics
NPI:1073049516
Name:KASSEM, KAMAL MOHAMED-AYED (MD)
Entity Type:Individual
Prefix:
First Name:KAMAL
Middle Name:MOHAMED-AYED
Last Name:KASSEM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:201 ABRAHAM FLEXNER WAY
Mailing Address - Street 2:RUDD HEART & LUNG BLDG, SUITE 600
Mailing Address - City:LOUIVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202
Mailing Address - Country:US
Mailing Address - Phone:502-852-1845
Mailing Address - Fax:
Practice Address - Street 1:201 ABRAHAM FLEXNER WAY
Practice Address - Street 2:RUDD HEART & LUNG BLDG, SUITE 600
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202
Practice Address - Country:US
Practice Address - Phone:502-852-1845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY53759207R00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine