Individual
BASSEL BARDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1216 RYANS RD, WORTHINGTON, MN 56187-1722
(507) 372-2921
(507) 372-5789
Mailing address
1216 RYANS RD, WORTHINGTON, MN 56187-1722
(507) 372-2921
(507) 372-5789
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
39465
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120955
UCARE
MN
05
—
1909333
—
IA
01
—
370010988
RR MEDICARE
MN
05
—
539817700
—
MN
01
—
54A03BA
BCBS MPIN
MN
Enumeration date
10/03/2006
Last updated
05/26/2015
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