Provider Demographics
NPI:1134476997
Name:QASSIM UNIVERSITY
Entity Type:Organization
Organization Name:QASSIM UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE DEAN QUALITY & DEVELOPMENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDULRAHMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-MOHAIMEED
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MHPE
Authorized Official - Phone:009666-380-0050
Mailing Address - Street 1:QASSIM UNIVERSITY COLLEGE OF MEDICINE, DEPT OF FAMILY/
Mailing Address - Street 2:COMMUNITY MED, ROOM 3061
Mailing Address - City:MULAIDAH
Mailing Address - State:ALQASSIM
Mailing Address - Zip Code:51442
Mailing Address - Country:SA
Mailing Address - Phone:009666-380-0050
Mailing Address - Fax:0096663800-050-2076
Practice Address - Street 1:QASSIM UNIVERSITY, DEPT OF FAMILY MEDICINE
Practice Address - Street 2:ROOM 3061
Practice Address - City:MULAIDAH
Practice Address - State:ALQASSIM
Practice Address - Zip Code:51442
Practice Address - Country:SA
Practice Address - Phone:009666-380-0050
Practice Address - Fax:0096663800-050-2076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-12
Last Update Date:2012-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ30988-S261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care