Individual
BASANTA K MOHAPATRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3622 BELMONT AVE, SUITE 1, YOUNGSTOWN, OH 44505-1450
(330) 759-9350
(330) 759-9387
Mailing address
3622 BELMONT AVE, SUITE 1, YOUNGSTOWN, OH 44505-1450
(330) 759-9350
(330) 759-9387
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
35078344M
OH
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
35078344
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2215132
—
OH
Enumeration date
09/13/2005
Last updated
03/09/2011
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