MEDICARE: DR. BASIL EDWIN WEST JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	D0094091	MD

General Provider Information

NPI Number	:	1023578978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BASIL EDWIN WEST JR. MD

Provider Business Mailing Address
First Line	:	250 W PRATT ST STE 1320
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21201-2411
Country	:	US
Telephone Number	:	443-643-6821
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 W PRATT ST STE 1320
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21201-2411
Country	:	US
Telephone Number	:	443-643-6821
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2019
Last Update Date	:	01/29/2023

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