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General NPI Number Information
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NPI Number | 1407826233
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Entity Type | Individual
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Provider Name | ASHISH KUMAR BASU M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 09/25/2009
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Provider Practice Location Address
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Address Line | 2424 DANVILLE RD SW SUITE L
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City | DECATUR
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State | AL
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Zip | 35603-4280
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Country | US
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Telephone | 256-351-0688
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Fax | 256-353-8894
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Provider Business Mailing Address
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Address Line | 930 FRANKLIN ST SE
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City | HUNTSVILLE
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State | AL
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Zip | 35801-4312
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Country | US
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Telephone | 256-539-4080
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Fax | 256-539-4099
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 22653
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License Number State | AL
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