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Individual

DR. ASISH K BASU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
501 VAN BUREN ST, SUITE 206, FOSTORIA, OH 44830-1534
(419) 435-7734
(419) 437-6623
Mailing address
501 VAN BUREN ST, SUITE 206, FOSTORIA, OH 44830-1534
(419) 435-7734
(419) 437-6623

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35064587
OH
207RC0000X
Cardiovascular Disease Physician
Primary
35064587
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000387005
ANTHEM
OH
05
0978170
OH
01
14-52073
UHC
OH
01
4528172
AETNA
OH
01
P00294496
RRMC
OH
Enumeration date
09/08/2005
Last updated
03/22/2012
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