Provider Demographics
NPI:1043312150
Name:BASHA, MOHAMMED MUNEER (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:MUNEER
Last Name:BASHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10424 SW 8TH LN
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-6353
Mailing Address - Country:US
Mailing Address - Phone:352-332-4131
Mailing Address - Fax:352-369-3324
Practice Address - Street 1:410 N MAIN ST STE 1AND2
Practice Address - Street 2:
Practice Address - City:CHIEFLAND
Practice Address - State:FL
Practice Address - Zip Code:32626-0866
Practice Address - Country:US
Practice Address - Phone:352-493-7274
Practice Address - Fax:352-496-9290
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME62122207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine