Healthcare Provider Details

I. General information

NPI: 1225123318
Provider Name (Legal Business Name): CRAIG NICOLAS BASH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7831 WOODMONT AVE
BETHESDA MD
20814-3007
US

IV. Provider business mailing address

7831 WOODMONT AVE
BETHESDA MD
20814-3007
US

V. Phone/Fax

Practice location:
  • Phone: 301-767-9525
  • Fax:
Mailing address:
  • Phone: 301-767-9525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberD43471
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: