1346231834 NPI number — CAMILLE NASIM BITAR M.D.

Table of content: CAMILLE NASIM BITAR M.D. (NPI 1346231834)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346231834 NPI number — CAMILLE NASIM BITAR M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BITAR
Provider First Name:
CAMILLE
Provider Middle Name:
NASIM
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BITAR
Provider Other First Name:
KAMIL
Provider Other Middle Name:
NASIM
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1346231834
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/25/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 608
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SLIDELL
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70459-0608
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-643-0075
Provider Business Mailing Address Fax Number:
985-646-0430

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7020 WEST HIGHWAY 190
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
COVINGTON
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-643-0075
Provider Business Practice Location Address Fax Number:
985-643-0430
Provider Enumeration Date:
11/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2080P0208X , with the licence number:  MD.09189R , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0200X , with the licence number: 09189R , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RI0200X , with the licence number: 15537 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0001098501 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 370010228 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 1994961 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00118407 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




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