Provider Demographics
NPI:1003944604
Name:BASHAR, BELA ROSA (MD)
Entity Type:Individual
Prefix:DR
First Name:BELA
Middle Name:ROSA
Last Name:BASHAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17 BAKER CIR
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3203
Mailing Address - Country:US
Mailing Address - Phone:617-442-8800
Mailing Address - Fax:617-541-8472
Practice Address - Street 1:55 DIMOCK ST
Practice Address - Street 2:DIMOCK COMMUNITY HEALTH CENTER
Practice Address - City:ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02119-1029
Practice Address - Country:US
Practice Address - Phone:617-442-8800
Practice Address - Fax:617-541-8472
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA157683207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAH28938Medicare UPIN