Healthcare Provider Details
I. General information
NPI: 1144262650
Provider Name (Legal Business Name): ALLIANCE PULMONARY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/11/2006
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
270 E STATE ST SUITE #240
ALLIANCE OH
44601
US
IV. Provider business mailing address
270 E STATE ST SUITE #240
ALLIANCE OH
44601
US
V. Phone/Fax
- Phone: 330-596-6560
- Fax: 330-823-6449
- Phone: 330-596-6560
- Fax: 330-823-6449
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | 35078091 |
| License Number State | OH |
VIII. Authorized Official
Name: DR.
ABDUL
BASIT
BASIT
Title or Position: SOLE OWNER
Credential: MD
Phone: 330-596-6560