Individual
STEPHEN T BASHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1505 NORTHSIDE BLVD, SUITE 3500, CUMMING, GA 30041-7623
(770) 886-3555
(770) 205-6501
Mailing address
1505 NORTHSIDE BLVD, SUITE 3500, CUMMING, GA 30041-7623
(770) 886-3555
(770) 205-6501
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
46040
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000909565J
—
GA
Enumeration date
06/28/2006
Last updated
03/28/2012
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