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General NPI Number Information
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NPI Number | 1497745061
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Entity Type | Individual
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Provider Name | ERIC NILE BASMAJI M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 06/26/2017
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Provider Practice Location Address
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Address Line | 416 CONNABLE AVENUE NORTHERN MICHIGAN REGIONAL HOSPITAL
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City | PETOSKEY
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State | MI
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Zip | 49770
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Country | US
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Telephone | 231-487-4000
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Fax | 248-476-1780
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Provider Business Mailing Address
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Address Line | 416 CONNABLE AVENUE NORTHERN MICHIGAN REGIONAL HOSPITAL
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City | PETOSKEY
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State | MI
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Zip | 49770
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Country | US
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Telephone | 231-487-4000
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Fax | 248-476-1780
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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 | EB072525
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 4301072525
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License Number State | MI
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