Provider Demographics
NPI:1942441357
Name:HACHEM, SAHAR BASSAM (MD)
Entity Type:Individual
Prefix:
First Name:SAHAR
Middle Name:BASSAM
Last Name:HACHEM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 E 32ND ST N STE 125
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2644
Mailing Address - Country:US
Mailing Address - Phone:316-330-3636
Mailing Address - Fax:
Practice Address - Street 1:8110 E 32ND ST N STE 125
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2644
Practice Address - Country:US
Practice Address - Phone:316-330-2525
Practice Address - Fax:866-378-4552
Is Sole Proprietor?:No
Enumeration Date:2009-03-13
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-33379207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200631580AMedicaid
KS200631580DMedicaid
KS004052012Medicare PIN
KS111078008Medicare UPIN
KS200631580AMedicaid
KSP01335042Medicare PIN