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NPI Code Detail

MEDICARE: GREGORY G. BASTING M.D.

MEDICARE: GREGORY G. BASTING M.D.
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
1208100000XPhysical Medicine & Rehabilitation PhysicianMD034396LPA

Other Identifiers

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

General Provider Information

NPI Number : 1255324729
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY G. BASTING M.D.
Provider Business Mailing Address
First Line : 150 MUNDY ST
Second Line :
City : WILKES BARRE
State : PA
Zip : 18702-6830
Country : US
Telephone Number : 570-824-0930
Fax Number : 570-824-7755
Provider Business Practice Location Address
First Line : 150 MUNDY ST
Second Line :
City : WILKES BARRE
State : PA
Zip : 18702-6830
Country : US
Telephone Number : 570-824-0930
Fax Number : 570-824-7755
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 02/25/2008

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Directions to “ GREGORY G. BASTING M.D.” Practice Location

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