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NPI Code Detail

MEDICARE: KENDRICK B BASHOR MD

MEDICARE: KENDRICK B BASHOR 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
1207Q00000XFamily Medicine Physician35063767BOH

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 : 1457355083
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDRICK B BASHOR MD
Provider Business Mailing Address
First Line : 40 MUNROE FALLS AVE
Second Line :
City : MUNROE FALLS
State : OH
Zip : 44262-1538
Country : US
Telephone Number : 330-923-0553
Fax Number : 330-923-0556
Provider Business Practice Location Address
First Line : 96 GRAHAM RD
Second Line : SUITE B
City : CUYAHOGA FALLS
State : OH
Zip : 44223-1205
Country : US
Telephone Number : 330-923-0553
Fax Number : 330-923-0556
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2005
Last Update Date : 03/07/2018

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Directions to “ KENDRICK B BASHOR MD” Practice Location

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