Provider Demographics
NPI:1124386677
Name:ANDRAOUS, WESAM F (MD)
Entity Type:Individual
Prefix:
First Name:WESAM
Middle Name:F
Last Name:ANDRAOUS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:STONY BROOK ANAESTHESIOLOGY UFPC
Mailing Address - Street 2:STONY BROOK UNIVERSITY,HEALTH SCIENCE CENTER LEVEL 4, #
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8480
Mailing Address - Country:US
Mailing Address - Phone:631-444-2975
Mailing Address - Fax:631-444-2907
Practice Address - Street 1:STONY BROOK ANAESTHESIOLOGY UFPC
Practice Address - Street 2:STONY BROOK UNIVERSITY,HEALTH SCIENCE CENTER LEVEL 4, #
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8480
Practice Address - Country:US
Practice Address - Phone:631-444-2975
Practice Address - Fax:631-444-2907
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2014-06-03
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Provider Licenses
StateLicense IDTaxonomies
NY60 273739207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY60 273739OtherSTATE LICENSE