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Individual

DR. PHILIP ANTHONY BASALA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
POTOMAC VALLEY HOSPITAL, 100 PIN OAK LANE, KEYSER, WV 26726
(304) 597-3510
(304) 597-3513
Mailing address
328 SUNNY MEADOWS LN, SWANTON, MD 21561-2677
(412) 848-2631

Taxonomy

Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
1245
WV
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
H0099654
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0012925630006
PA
Enumeration date
07/30/2006
Last updated
04/04/2024
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