Healthcare Provider Details

I. General information

NPI: 1508815663
Provider Name (Legal Business Name): THOMAS E BASCO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 OMNI BLVD STE 110
NEWPORT NEWS VA
23606-4430
US

IV. Provider business mailing address

860 OMNI BLVD STE 110
NEWPORT NEWS VA
23606-4430
US

V. Phone/Fax

Practice location:
  • Phone: 757-223-9794
  • Fax: 757-223-9168
Mailing address:
  • Phone: 757-223-9794
  • Fax: 757-223-9168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101102807
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: