Provider Demographics
NPI:1700822608
Name:BASHIR, ABID (MD)
Entity Type:Individual
Prefix:DR
First Name:ABID
Middle Name:
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 1:5105 JEFFERSON RD # B
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30607-1701
Mailing Address - Country:US
Mailing Address - Phone:706-227-4075
Mailing Address - Fax:706-227-4086
Practice Address - Street 1:5105 JEFFERSON RD
Practice Address - Street 2:SUITE B
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30607-1701
Practice Address - Country:US
Practice Address - Phone:706-227-4075
Practice Address - Fax:706-227-4086
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA050865207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000935789MMedicaid
GA000935789TMedicaid
GA000935789VMedicaid
GA3100152OtherUNITED HEALTH
GA000935789SMedicaid
GA000935789NMedicaid
GA000935789PMedicaid
GA000935789WMedicaid
GAP00076801OtherMEDICARE RAIL ROAD
GA000935789IMedicaid
GA000935789HMedicaid
GA000935789KMedicaid
GA000935789LMedicaid
GA000935789OMedicaid
GA0888410OtherCIGNA
GA5628203OtherAETNA PPO
GA000935789QMedicaid
GA000935789RMedicaid
GA10035059OtherAMERIGROUP
GA2917383OtherAETNA HMO
GA52834554 005OtherBLUE CROSS BLUE SHIELD
GA000935789AMedicaid
GA000935789JMedicaid
GA000935789UMedicaid
GA346327OtherWELLCARE
GA000935789UMedicaid
GA000935789LMedicaid