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Individual

MICHAEL A BASARGIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
64280 NAHODKA DR, NIKOLAEVSK, AK 99556
(907) 299-6453
(907) 235-6453
Mailing address
PO BOX 2000, HOMER, AK 99603-2000
(907) 299-6453
(907) 235-6453

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
28472
AK
171WH0202X
Home Modifications Contractor
287549
AK

Other

Enumeration date
09/01/2011
Last updated
09/01/2011
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