Individual
AYESHA BASHIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
54 HOSPITAL DR, STE 204, OSAGE BEACH, MO 65065-3050
(573) 302-3960
(573) 348-8217
Mailing address
PO BOX 1500, OSAGE BEACH, MO 65065-1500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2012026875
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780828657
—
MO
Enumeration date
04/23/2009
Last updated
05/01/2023
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