Provider Demographics
NPI:1235335886
Name:BASHAM, HILARY FITZGERALD (DO)
Entity Type:Individual
Prefix:
First Name:HILARY
Middle Name:FITZGERALD
Last Name:BASHAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:HILARY
Other - Middle Name:FITZGERALD
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:1613 OAKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-1213
Mailing Address - Country:US
Mailing Address - Phone:540-586-2441
Mailing Address - Fax:
Practice Address - Street 1:1613 OAKWOOD ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-1213
Practice Address - Country:US
Practice Address - Phone:540-586-2441
Practice Address - Fax:484-884-2885
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60215525207P00000X
PAOS015022207P00000X
PAOT011922207P00000X
VA0102203416207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine