Provider Demographics
NPI:1326314352
Name:BASSI, SUMIT (MD)
Entity Type:Individual
Prefix:
First Name:SUMIT
Middle Name:
Last Name:BASSI
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 1:510 UPPER CHESAPEAKE DR
Mailing Address - Street 2:SUITE 417
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4328
Mailing Address - Country:US
Mailing Address - Phone:443-643-3130
Mailing Address - Fax:
Practice Address - Street 1:510 UPPER CHESAPEAKE DR
Practice Address - Street 2:SUITE 417
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4328
Practice Address - Country:US
Practice Address - Phone:443-643-3130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-23
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0082134207QS0010X
OH35.127356207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine