MEDICARE: DR. MUHAMMAD OMER BASHIR 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
1	208M00000X	Hospitalist Physician	247070	NY
2	207R00000X	Internal Medicine Physician	247070	NY
3	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	247070	NY

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710984703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MUHAMMAD OMER BASHIR M.D.

Provider Business Mailing Address
First Line	:	146 AUTUMN CHASE DR
Second Line	:
City	:	HOPEWELL JUNCTION
State	:	NY
Zip	:	12533-6574
Country	:	US
Telephone Number	:	631-627-9987
Fax Number	:

Provider Business Practice Location Address
First Line	:	146 AUTUMN CHASE DR
Second Line	:
City	:	HOPEWELL JUNCTION
State	:	NY
Zip	:	12533-6574
Country	:	US
Telephone Number	:	631-627-9987
Fax Number	:

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	09/15/2017

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