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General NPI Number Information
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NPI Number | 1023759214
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Entity Type | Individual
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Provider Name | ADAM BASHA D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 2520 ROBERT JONES WAY
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City | KALAMAZOO
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State | MI
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Zip | 49009-1904
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Country | US
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Telephone | 269-375-0400
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Fax | 269-492-0660
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Provider Business Mailing Address
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Address Line | 3245 HEALTH DR STE 100
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City | GRANGER
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State | IN
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Zip | 46530-1380
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Country | US
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Telephone | 269-552-2823
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Fax | 269-552-2964
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 5101028757
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License Number State | MI
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