Provider Demographics
NPI:1710183678
Name:BASHOUR, MOUNIR (MD, CM, PHD, FRCSC,)
Entity Type:Individual
Prefix:MR
First Name:MOUNIR
Middle Name:
Last Name:BASHOUR
Suffix:
Gender:M
Credentials:MD, CM, PHD, FRCSC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 RENE-LEVEQUES OUEST
Mailing Address - Street 2:LEVEL MD NIVEAU MD
Mailing Address - City:MONTREAL
Mailing Address - State:QUEBEC
Mailing Address - Zip Code:H3B 4W8
Mailing Address - Country:CA
Mailing Address - Phone:514-904-2870
Mailing Address - Fax:514-904-0040
Practice Address - Street 1:1304 BUCKLEY RD
Practice Address - Street 2:SUITE 301
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-4302
Practice Address - Country:US
Practice Address - Phone:315-413-0880
Practice Address - Fax:315-413-0866
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY218908207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology