MEDICARE: DR. AMIT BASU MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MD071796L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013989326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMIT BASU MD

Provider Business Mailing Address
First Line	:	200 LOTHROP ST
Second Line	:	SUITE 9055 FORBES TOWER
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-2536
Country	:	US
Telephone Number	:	412-647-3087
Fax Number	:

Provider Business Practice Location Address
First Line	:	3459 5TH AVE
Second Line	:	N725
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-3236
Country	:	US
Telephone Number	:	412-647-5730
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	01/18/2013

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