Individual
ROBERT L BASISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2600 6TH ST SW, RADIOLOGY ASSOCIATES OF CANTON, INC., CANTON, OH 44710-1702
(330) 363-2842
(330) 580-5536
Mailing address
P.O. BOX 72384, RADIOLOGY ASSOCIATES OF CANTON, INC., CLEVELAND, OH 44192
(888) 686-1837
(330) 686-5928
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35 040882
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0432802
—
OH
01
—
300083227
RAILROAD MEDICARE
OH
Enumeration date
11/01/2005
Last updated
01/04/2011
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