Individual
DR. JESSICA MARIE BASHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
515 N LAFAYETTE BLVD, SOUTH BEND, IN 46601-1003
(574) 232-2037
(574) 232-1470
Mailing address
6301 UNIVERSITY COMMONS STE 230, SOUTH BEND, IN 46635-1590
(574) 251-2100
(574) 251-2150
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01078045A
IN
Other
Enumeration date
03/20/2013
Last updated
01/10/2018
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