Individual
BASHEER SUFYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3925 NW 43RD ST, GAINESVILLE, FL 32606-4565
(352) 371-1777
Mailing address
3925 NW 43RD ST, GAINESVILLE, FL 32606-4565
(517) 706-9777
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5508
CT
363A00000X
Physician Assistant
Primary
5601006608
MI
Other
Enumeration date
03/01/2013
Last updated
12/09/2021
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