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General NPI Number Information
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NPI Number | 1023597895
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Entity Type | Individual
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Provider Name | SIDHARTH BHASIN MD
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Gender | Male
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Dates
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Enumeration Date | 08/12/2018
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER DR
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City | MORGANTOWN
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State | WV
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Zip | 26506-1200
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Country | US
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Telephone | 855-988-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 10 LANDING LN APT 5E
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1038
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Country | US
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Telephone | 848-252-4842
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 33690
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License Number State | WV
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