Provider Demographics
NPI:1710952098
Name:KASSIR, WALID A (MD)
Entity Type:Individual
Prefix:DR
First Name:WALID
Middle Name:A
Last Name:KASSIR
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 1:10 LIBERTY LN
Mailing Address - Street 2:PO BOX 737
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-2772
Mailing Address - Country:US
Mailing Address - Phone:724-537-9208
Mailing Address - Fax:724-537-0867
Practice Address - Street 1:10 LIBERTY LN
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-2772
Practice Address - Country:US
Practice Address - Phone:724-537-9208
Practice Address - Fax:724-537-0867
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425415207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAI49368Medicare UPIN
PA098281JF6Medicare ID - Type Unspecified