Provider Demographics
NPI:1750325957
Name:AQEL, BASHAR AHMED (MD)
Entity Type:Individual
Prefix:DR
First Name:BASHAR
Middle Name:AHMED
Last Name:AQEL
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 1:13400 E SHEA BLVD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-5452
Mailing Address - Country:US
Mailing Address - Phone:480-301-8000
Mailing Address - Fax:
Practice Address - Street 1:13400 E SHEA BLVD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-5452
Practice Address - Country:US
Practice Address - Phone:480-301-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46655207R00000X, 207RG0100X
AZ37647207RI0008X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN732646700Medicaid
MT0152626Medicaid
MN1042010OtherPREFERRED ONE
MN2230944OtherARAZ
MN29-00402OtherMEDICA - CHOICE
AZP00473344OtherRAILROAD MEDICARE
IA0579615Medicaid
MN29-00011OtherMEDICA PRIMARY
MN609R4AQOtherBCBS
AZ297842Medicaid
MNHP46704OtherHEALTHPARTNERS
MNA032OtherCHAMPUS/TRIWEST
MN132335OtherUCARE
MNP00206464Medicare ID - Type UnspecifiedRAILROAD MEDICARE
AZ297842Medicaid
MN2230944OtherARAZ
MN732646700Medicaid