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General NPI Number Information
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NPI Number | 1427071059
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Entity Type | Individual
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Provider Name | JAVAID M BASHIR M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 01/29/2010
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Provider Practice Location Address
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Address Line | 1034 4TH ST MULTIPLE OFFICE LOCATIONS
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City | JACKSON
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State | MI
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Zip | 49203-3060
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Country | US
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Telephone | 517-392-1651
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Fax | 734-484-0529
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Provider Business Mailing Address
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Address Line | 1034 4TH ST
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City | JACKSON
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State | MI
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Zip | 49203-3060
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Country | US
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Telephone | 517-392-1651
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Fax | 734-484-0529
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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 | 4301047107
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301047107
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 4301047107
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License Number State | MI
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