Individual
ALFONSO J. BASILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
410 W 10TH AVE, COLUMBUS, OH 43210-1240
(614) 293-8487
(614) 293-8153
Mailing address
700 ACKERMAN RD, SUITE 570, COLUMBUS, OH 43202-1559
(614) 293-2046
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35061934
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000381912
ANTHEM
OH
05
—
0893172
—
OH
Enumeration date
01/30/2006
Last updated
07/29/2015
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