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General NPI Number Information
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NPI Number | 1255312732
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Entity Type | Individual
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Provider Name | MICHAEL J BASSAN DC
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Gender | Male
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 06/16/2015
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Provider Practice Location Address
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Address Line | 540 E BELVEDERE AVE SUITE 200
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City | BALTIMORE
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State | MD
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Zip | 21212-3750
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Country | US
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Telephone | 410-323-4500
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Fax | 410-323-5883
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Provider Business Mailing Address
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Address Line | 9601 PULASKI PARK DR SUITE 416
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-1409
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Country | US
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Telephone | 410-933-5678
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Fax | 410-933-1823
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | S01110
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License Number State | MD
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