Provider Demographics
NPI:1346231834
Name:BITAR, CAMILLE NASIM (MD)
Entity type:Individual
Prefix:
First Name:CAMILLE
Middle Name:NASIM
Last Name:BITAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KAMIL
Other - Middle Name:NASIM
Other - Last Name:BITAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70459-0608
Mailing Address - Country:US
Mailing Address - Phone:985-643-0075
Mailing Address - Fax:985-646-0430
Practice Address - Street 1:7015 HIGHWAY 190 EAST SERVICE RD STE 200
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-4960
Practice Address - Country:US
Practice Address - Phone:985-643-0075
Practice Address - Fax:985-643-0430
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS15537207RI0200X
LAMD.09189R2080P0208X
LA09189R207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0001098501Medicaid
LA1994961Medicaid
LA370010228OtherRAILROAD MEDICARE
MS00118407Medicaid
LA5U696Medicare PIN
MS00118407Medicaid
LA370010228OtherRAILROAD MEDICARE