Provider Demographics
NPI:1285637314
Name:ABI-RACHED, BASSAM (MD)
Entity Type:Individual
Prefix:DR
First Name:BASSAM
Middle Name:
Last Name:ABI-RACHED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:605 MEDICAL CENTER DR STE B
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-8145
Mailing Address - Country:US
Mailing Address - Phone:318-442-2232
Mailing Address - Fax:318-442-2192
Practice Address - Street 1:605B MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8127
Practice Address - Country:US
Practice Address - Phone:318-442-2232
Practice Address - Fax:318-442-2192
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA14847R207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1148393Medicaid
LA1148393Medicaid
LAG39354Medicare UPIN