Provider Demographics
NPI:1366649014
Name:KASSAB, FIRAS (MD)
Entity Type:Individual
Prefix:
First Name:FIRAS
Middle Name:
Last Name:KASSAB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FIRAS
Other - Middle Name:
Other - Last Name:ALKASSAB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8840 BLAKENEY PROFESSIONAL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-6806
Mailing Address - Country:US
Mailing Address - Phone:704-672-0449
Mailing Address - Fax:866-469-2745
Practice Address - Street 1:8840 BLAKENEY PROFESSIONAL DR STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-6806
Practice Address - Country:US
Practice Address - Phone:704-672-0449
Practice Address - Fax:866-469-2745
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-00127207RR0500X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1366649014Medicaid
MA2137763Medicaid
NC5915888Medicaid
SCNC1238Medicaid
NC2076426Medicare PIN
NC2076426AMedicare PIN
SCNC1238Medicaid