Provider Demographics
NPI:1285643296
Name:SAYEGH, BASSAM (MD)
Entity Type:Individual
Prefix:
First Name:BASSAM
Middle Name:
Last Name:SAYEGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 CHIMNEY CORNER LN
Mailing Address - Street 2:SUITE #1026
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-4800
Mailing Address - Country:US
Mailing Address - Phone:561-743-7766
Mailing Address - Fax:561-744-6020
Practice Address - Street 1:224 CHIMNEY CORNER LN
Practice Address - Street 2:SUITE #1026
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-4800
Practice Address - Country:US
Practice Address - Phone:561-743-7766
Practice Address - Fax:561-744-6020
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76049208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255759200Medicaid
FL43770Medicare ID - Type Unspecified
FL255759200Medicaid