Individual
MICHAEL H BASISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5700 MONROE ST UNIT 103, SYLVANIA, OH 43560-2771
(419) 843-7996
(419) 841-7725
Mailing address
ONE SEAGATE, SUITE 800, TOLEDO, OH 43604
(419) 824-7250
(419) 885-3921
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
35052150B
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000581398
ANTHEM
—
01
—
01309
PARAMOUNT
—
05
—
0816040
—
OH
01
—
4290317
AETNA
—
05
—
4632355
—
MI
05
—
4796124
—
MI
05
—
4796142
—
MI
01
—
P00659818
RAILROAD MEDICARE
—
Enumeration date
10/03/2005
Last updated
11/03/2023
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