Provider Demographics
NPI:1316185408
Name:BASI, HARJIT S (MD)
Entity Type:Individual
Prefix:
First Name:HARJIT
Middle Name:S
Last Name:BASI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-5736
Mailing Address - Country:US
Mailing Address - Phone:207-626-1561
Mailing Address - Fax:207-626-1849
Practice Address - Street 1:15 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5736
Practice Address - Country:US
Practice Address - Phone:207-626-1561
Practice Address - Fax:207-626-1849
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MEEC091002207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1316185408Medicaid