MEDICARE: DR. ROBERT M. BASARAB 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	2085R0202X	Diagnostic Radiology Physician	MD028803E	PA
2	207U00000X	Nuclear Medicine Physician	MD028803E	PA
3	2085N0904X	Nuclear Radiology Physician	MD028803E	PA
4	207UN0902X	Nuclear Imaging & Therapy Physician	MD028803E	PA
5	207UN0901X	Nuclear Cardiology Physician	MD028803E	PA
6	207UN0903X	In Vivo & In Vitro Nuclear Medicine Physician	MD028803E	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	300047027	OTHER	PA	RAILROAD MEDICARE
4	129377YYY	OTHER	PA	MEDICARE PTAN

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
3	129377	OTHER	PA	HIGHMARK BLUE SHIELD
5	1521152	OTHER	PA	GATEWAY
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	30123079	OTHER	PA	AMERIHEALTH MERCY

General Provider Information

NPI Number	:	1932102399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT M. BASARAB M.D.

Provider Business Mailing Address
First Line	:	3421 CONCORD RD
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-9001
Country	:	US
Telephone Number	:	717-812-4083
Fax Number	:	717-812-2244

Provider Business Practice Location Address
First Line	:	35 MONUMENT RD
Second Line	:	SUITE 201
City	:	YORK
State	:	PA
Zip	:	17403-5074
Country	:	US
Telephone Number	:	717-812-4083
Fax Number	:	717-812-2244

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	06/30/2016

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