Provider Demographics
NPI:1114230430
Name:BASHIR, MUHAMMAD H (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:H
Last Name:BASHIR
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 1:385 HAWTHORNE LN STE 200
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2100
Mailing Address - Country:US
Mailing Address - Phone:706-543-3130
Mailing Address - Fax:706-543-3215
Practice Address - Street 1:385 HAWTHORNE LN STE 200
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2100
Practice Address - Country:US
Practice Address - Phone:706-543-3130
Practice Address - Fax:706-543-3215
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA070340207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN110013592Medicare PIN