Provider Demographics
NPI:1134803646
Name:SAADEH, ASEEL BASSAM MOHD
Entity type:Individual
Prefix:
First Name:ASEEL
Middle Name:BASSAM MOHD
Last Name:SAADEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NORTH ACADEMY AVENUE, GEISINGER MEDICAL CENTER
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822
Mailing Address - Country:US
Mailing Address - Phone:570-271-6787
Mailing Address - Fax:
Practice Address - Street 1:100 NORTH ACADEMY AVENUE, GEISINGER MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822
Practice Address - Country:US
Practice Address - Phone:570-271-6787
Practice Address - Fax:570-271-5734
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2024-01-25
Deactivation Date:2024-01-17
Deactivation Code:
Reactivation Date:2024-01-25
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMT228864207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program