Provider Demographics
NPI:1518106871
Name:GEORGE, BASSEM RAGHEB (MD)
Entity Type:Individual
Prefix:DR
First Name:BASSEM
Middle Name:RAGHEB
Last Name:GEORGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 W ELM ST
Mailing Address - Street 2:STE 100
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-4108
Mailing Address - Country:US
Mailing Address - Phone:215-255-7822
Mailing Address - Fax:215-255-7825
Practice Address - Street 1:230 N BROAD ST
Practice Address - Street 2:HAHNEMANN UNIVERSITY HOSPITAL/ DREXEL UNIVERSITY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1121
Practice Address - Country:US
Practice Address - Phone:215-762-2514
Practice Address - Fax:215-762-7701
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV27541207P00000X
NHLT4402207P00000X
PAMD445231207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102700163Medicaid
PAMT191253OtherMT LICENSE
PAMT191253OtherMT LICENSE