Provider Demographics
NPI:1790744472
Name:BASSI, ASHWANI KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHWANI
Middle Name:KUMAR
Last Name:BASSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:325 HOSPITAL DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5860
Mailing Address - Country:US
Mailing Address - Phone:410-863-8860
Mailing Address - Fax:410-766-7305
Practice Address - Street 1:325 HOSPITAL DR
Practice Address - Street 2:SUITE 108
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5860
Practice Address - Country:US
Practice Address - Phone:410-863-8860
Practice Address - Fax:410-766-7305
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDMD37250207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD072QMedicare ID - Type Unspecified
MDE66161Medicare UPIN