Provider Demographics
NPI:1164854659
Name:NAGM, HUSSAM YOUSEF (MBBS)
Entity Type:Individual
Prefix:
First Name:HUSSAM
Middle Name:YOUSEF
Last Name:NAGM
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7261 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2311
Mailing Address - Country:US
Mailing Address - Phone:402-717-4866
Mailing Address - Fax:
Practice Address - Street 1:7500 MERCY RD STE 1355
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124
Practice Address - Country:US
Practice Address - Phone:402-717-4866
Practice Address - Fax:402-818-2088
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE30661207L00000X
MA256349208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208600000XAllopathic & Osteopathic PhysiciansSurgery