Individual
CHRISTOPHER BASOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8501 E 56TH ST STE 120, INDIANAPOLIS, IN 46216-2118
(317) 621-2360
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02005341A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2016
Last updated
11/27/2023
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