Individual
NISHCHAYJIT S BASRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2400 17TH ST, COLUMBUS, IN 47201-5351
(812) 376-5974
(812) 375-3203
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 375-3000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
02005927A
IN
207R00000X
Internal Medicine Physician
2017017604
MO
208M00000X
Hospitalist Physician
Primary
02005927A
IN
Other
Enumeration date
06/09/2017
Last updated
09/06/2024
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