Ericsoussi, Bassel

Ericsoussi, Bassel is an sole proprietor health care provider with primary practice located at 761 45Th St Ste 108 , Munster IN 46321-2899. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Ericsoussi, Bassel can be contacted via phone (219) 922-5416.

Contact Information

Primary practice address
761 45Th St Ste 108 Munster IN 46321-2899
Phone: (219) 922-5416
Fax: (219) 922-3745
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 01069620A Indiana
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 01069620A Indiana

Profile Details

NPI number 1700087632
LBN Legal business name Ericsoussi, Bassel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 29th, 2007
Last updated Jul 5th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700087632 NPPES
Indiana MEDICAID 201063870

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