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Individual

DR. AMAYA MARIE BASTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-6241
(866) 320-4573
Mailing address
64 HOMESTEAD DR, BOISE, ID 83716-3018
(206) 484-0907

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
115078
CA
2085R0202X
Diagnostic Radiology Physician
340687
LA
2085R0202X
Diagnostic Radiology Physician
Primary
M13201
ID

Other

Enumeration date
06/25/2009
Last updated
01/17/2025
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