Basic Information
| Provider Information | |||||||||
| NPI: | 1952334195 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NEMRI | ||||||||
| FirstName: | GHASSAN | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 112 | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992100112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094646208 | ||||||||
| FaxNumber: | 8883161928 | ||||||||
| Practice Location | |||||||||
| Address1: | 3124 S REGAL ST | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992234704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5094646208 | ||||||||
| FaxNumber: | 8883161928 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2006 | ||||||||
| LastUpdateDate: | 08/26/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 01048531A | IN | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 200199070A | 05 | IN | MEDICAID |