Provider Demographics
NPI:1417916933
Name:KAMEL, HOSAM K (MD)
Entity Type:Individual
Prefix:
First Name:HOSAM
Middle Name:K
Last Name:KAMEL
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 1:2447 N WYCHWOOD CT
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-8403
Mailing Address - Country:US
Mailing Address - Phone:501-520-1489
Mailing Address - Fax:819-410-1391
Practice Address - Street 1:3601 S 6TH AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85723-6442
Practice Address - Country:US
Practice Address - Phone:501-520-1489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ60753207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR152740001Medicaid
G95141Medicare UPIN
AR5M656Medicare ID - Type Unspecified