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NPI Code Detail

MEDICARE: DAVID IAN BASS M.D.

MEDICARE: DAVID IAN BASS 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
1207T00000XNeurological Surgery Physician1013762MA
2207T00000XNeurological Surgery Physician103880GA

General Provider Information

NPI Number : 1831543925
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID IAN BASS M.D.
Provider Business Mailing Address
First Line : 75 FRANCIS ST
Second Line :
City : BOSTON
State : MA
Zip : 02115-6110
Country : US
Telephone Number : 617-732-5500
Fax Number :
Provider Business Practice Location Address
First Line : 2001 PEACHTREE RD NE STE 425
Second Line :
City : ATLANTA
State : GA
Zip : 30309-1423
Country : US
Telephone Number : 404-350-2404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2016
Last Update Date : 09/16/2025

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