Individual
ABDUL BASIT MIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
131 E REDSTONE AVE, SUITE 101, CRESTVIEW, FL 32539-5326
(850) 682-5174
(850) 689-3653
Mailing address
131 E REDSTONE AVE, SUITE 101, CRESTVIEW, FL 32539-5326
(850) 682-5174
(850) 689-3653
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0032883
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038080600
—
FL
Enumeration date
07/10/2006
Last updated
12/11/2009
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