Individual
BASANTA PATHAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
PEACEHEALTH HOSPITAL MEDICINE, 3377 RIVERBEND DRIVE, SPRINGFIELD, OR 97477-8803
(541) 222-6389
(541) 222-6385
Mailing address
PEACEHEALTH HOSPITAL MEDICINE, 3377 RIVERBEND DRIVE, SPRINGFIELD, OR 97477-8803
(541) 222-6389
(541) 222-6385
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
7780
SD
208M00000X
Hospitalist Physician
Primary
MD182576
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500724672
—
OR
Enumeration date
07/02/2010
Last updated
08/08/2023
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