Provider Demographics
NPI:1790569077
Name:BESHIR, HISHAM MOHAMMED
Entity Type:Individual
Prefix:
First Name:HISHAM
Middle Name:MOHAMMED
Last Name:BESHIR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16059 E OTERO PL
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-4601
Mailing Address - Country:US
Mailing Address - Phone:773-653-3330
Mailing Address - Fax:
Practice Address - Street 1:16059 E OTERO PL
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-4601
Practice Address - Country:US
Practice Address - Phone:773-653-3330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle