Individual
DR. BAHER A BASTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3800 POPLAR HILL RD STE A, CHESAPEAKE, VA 23321-5522
(757) 499-6978
(858) 925-1353
Mailing address
5234 DEFORD RD, VIRGINIA BEACH, VA 23455-7208
(757) 499-6978
(858) 925-1353
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101237664
VA
207RN0300X
Nephrology Physician
Primary
0101237664
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010296463
—
VA
Enumeration date
01/31/2006
Last updated
11/01/2021
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