Individual
DR. MICHAEL J BASILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4461 STARKEY ROAD, SUITE 201, ROANOKE, VA 24018
(540) 345-4946
(540) 343-7693
Mailing address
4461 STARKEY ROAD, SUITE 201, ROANOKE, VA 24018
(540) 345-4946
(540) 982-7164
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101029907
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110006376
MEDICARE
VA
01
—
110127672
RAILROAD MEDICARE
VA
05
—
1134166705
—
VA
Enumeration date
06/01/2006
Last updated
04/05/2011
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