Provider Demographics
NPI:1497194559
Name:BASHIR, TALHA (MD, MB,BS)
Entity Type:Individual
Prefix:DR
First Name:TALHA
Middle Name:
Last Name:BASHIR
Suffix:
Gender:M
Credentials:MD, MB,BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10337 MALCOLM CIR APT M
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-3881
Mailing Address - Country:US
Mailing Address - Phone:571-733-1734
Mailing Address - Fax:443-849-8030
Practice Address - Street 1:6565 N CHARLES ST STE 203
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-5805
Practice Address - Country:US
Practice Address - Phone:443-849-3760
Practice Address - Fax:443-849-8138
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2016-0153207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDN/AMedicaid
MDN/AMedicaid
N/AMedicare UPIN