Provider Demographics
NPI:1710984703
Name:BASHIR, MUHAMMAD OMER (MD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:OMER
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 1:146 AUTUMN CHASE DR
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6574
Mailing Address - Country:US
Mailing Address - Phone:631-627-9987
Mailing Address - Fax:
Practice Address - Street 1:146 AUTUMN CHASE DR
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-6574
Practice Address - Country:US
Practice Address - Phone:631-627-9987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY247070208M00000X, 207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02939137Medicaid
TN3890178Medicaid
TNI01884Medicare UPIN
TN3890178Medicaid