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Individual

BASHIR AWL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
0615

Contact information

Practice address
4130 ADALRIC DR, COLUMBUS, OH 43219-6199
(614) 749-9782
Mailing address
4130 ADALRIC DR, COLUMBUS, OH 43219-6199
(614) 749-9782

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
201703403310
OH

Other

Enumeration date
03/03/2017
Last updated
03/03/2017
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