Individual
AHMAD MOSSA-BASHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1515 N MADISON AVE, ANDERSON, IN 46011-3453
(765) 298-4242
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02005110A
IN
207R00000X
Internal Medicine Physician
02005110A
IN
208M00000X
Hospitalist Physician
Primary
02005110A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300004937
—
IN
Enumeration date
03/27/2014
Last updated
11/27/2023
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