Individual
BASIL C GENETOS
Active
Individual
BASIL C GENETOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01024857A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000641079
ANTHEM
IN
05
—
0528012
—
OH
01
—
060070579
RR MEDICARE
IN
05
—
100186010
—
IN
Enumeration date
08/15/2005
Last updated
11/28/2016
Update your record
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