Provider Demographics
NPI:1083670954
Name:ESSIET, BASSEY N (MD)
Entity Type:Individual
Prefix:
First Name:BASSEY
Middle Name:N
Last Name:ESSIET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:B
Other - Middle Name:NELSON
Other - Last Name:ESSIET
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:525 E MARKET ST
Mailing Address - Street 2:AKRON RADIOLOGY, INC.
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1619
Mailing Address - Country:US
Mailing Address - Phone:330-375-3043
Mailing Address - Fax:330-375-7932
Practice Address - Street 1:525 E MARKET ST
Practice Address - Street 2:AKRON RADIOLOGY, INC.
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1619
Practice Address - Country:US
Practice Address - Phone:330-375-3043
Practice Address - Fax:330-375-7932
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0625932085R0202X
OK248182085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0923899Medicaid
OK200079350AMedicaid
OHF53648Medicare UPIN
OHE50735764Medicare ID - Type Unspecified
OK200079350AMedicaid