Individual
DR. SAMEH A BASTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
ONE COLUMBUS CENTER, SUITE 600, 283 CONSTITUTION DRIVE, VIRGINIA BEACH, VA 23462
(757) 687-8190
Mailing address
ONE COLUMBUS CENTER, SUITE 600, 283 CONSTITUTION DRIVE, VIRGINIA BEACH, VA 23462
(757) 687-8190
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101054178
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006089836
—
VA
01
—
0637K
NC BC BS
NC
01
—
12881
SENTARA OHP/SHP
VA
01
—
238389
UNITED HEALTHCARE/MAMSI
VA
01
—
250839
ANTHEM
VA
05
—
890637K
—
NC
01
—
PAR
MID ATLANTIC/VICARE
VA
Enumeration date
02/01/2006
Last updated
08/21/2009
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