Individual
DR. CHRISTIAN BASQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
46 BARRA RD STE 103, BIDDEFORD, ME 04005-9461
(207) 283-1126
Mailing address
PO BOX 820933, PHILADELPHIA, PA 19182-0933
(215) 926-9010
(215) 226-8285
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD453023
PA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD21013
ME
207RS0010X
Sports Medicine (Internal Medicine) Physician
MD21013
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100727800
TPI GROUP PA MAID
PA
01
—
597586
TPI GROUP MEDICARE
PA
01
—
CD4829
TPI GROUP RAILROAD MEDICARE
PA
Enumeration date
04/07/2011
Last updated
01/23/2019
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