Provider Demographics
NPI:1003701673
Name:BASSAS, SAMAH (MD)
Entity type:Individual
Prefix:DR
First Name:SAMAH
Middle Name:
Last Name:BASSAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1278 E DARBY CIR
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-7317
Mailing Address - Country:US
Mailing Address - Phone:801-228-7228
Mailing Address - Fax:
Practice Address - Street 1:1278 E DARBY CIR
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84117-7317
Practice Address - Country:US
Practice Address - Phone:801-228-7228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8628786-1205207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine