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General NPI Number Information
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NPI Number | 1538153184
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Entity Type | Individual
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Provider Name | ASISH K BASU M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 03/22/2012
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Provider Practice Location Address
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Address Line | 501 VAN BUREN ST SUITE 206
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City | FOSTORIA
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State | OH
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Zip | 44830-1534
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Country | US
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Telephone | 419-435-7734
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Fax | 419-437-6623
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Provider Business Mailing Address
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Address Line | 501 VAN BUREN ST SUITE 206
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City | FOSTORIA
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State | OH
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Zip | 44830-1534
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Country | US
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Telephone | 419-435-7734
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Fax | 419-437-6623
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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 | 35064587
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 35064587
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License Number State | OH
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