Basic Information
| Provider Information | |||||||||
| NPI: | 1336372010 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALSAMARA | ||||||||
| FirstName: | MERSHED | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 550 GAGE BLVD STE 101 | ||||||||
| Address2: | |||||||||
| City: | RICHLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 993529532 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5099423627 | ||||||||
| FaxNumber: | 5096272983 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 GOETHALST DRIVE STE F | ||||||||
| Address2: | KADLEC INLAND CARDIOLOGY | ||||||||
| City: | RICHLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 99352 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5099423272 | ||||||||
| FaxNumber: | 5099423273 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2009 | ||||||||
| LastUpdateDate: | 01/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4301093773 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | MD60644313 | WA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 246XC2901X | MD60644313 | WA | N | Technologists, Technicians & Other Technical Service Providers | Spec/Tech, Cardiovascular | Cardiovascular Invasive Specialist | 246XC2901X | MD177136 | OR | N | Technologists, Technicians & Other Technical Service Providers | Spec/Tech, Cardiovascular | Cardiovascular Invasive Specialist | 207R00000X | MD60644313 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.