Provider Demographics
NPI:1891731873
Name:BASHIR, SALMAN (MD)
Entity Type:Individual
Prefix:
First Name:SALMAN
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 1:305 GREENWICH AVE
Mailing Address - Street 2:APT B302
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1637
Mailing Address - Country:US
Mailing Address - Phone:508-636-4521
Mailing Address - Fax:508-636-7160
Practice Address - Street 1:101 PAGE ST
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-3464
Practice Address - Country:US
Practice Address - Phone:508-636-4521
Practice Address - Fax:508-636-7160
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1509572085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3194434Medicaid
G69811Medicare UPIN
MAA28894Medicare ID - Type Unspecified