Provider Demographics
NPI:1376744920
Name:CARDIOVASCULAR & THORACIC SURGERY
Entity Type:Organization
Organization Name:CARDIOVASCULAR & THORACIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAZEM
Authorized Official - Middle Name:
Authorized Official - Last Name:BARMADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:228-769-2550
Mailing Address - Street 1:4211 HOSPITAL ST
Mailing Address - Street 2:SUITE302
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39581-5320
Mailing Address - Country:US
Mailing Address - Phone:228-769-2550
Mailing Address - Fax:228-769-2602
Practice Address - Street 1:4211 HOSPITAL ST
Practice Address - Street 2:SUITE302
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39581-5320
Practice Address - Country:US
Practice Address - Phone:228-769-2550
Practice Address - Fax:228-769-2602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS16903174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09015766Medicaid
MSE89882Medicare UPIN