Provider Demographics
NPI:1982671384
Name:BASH, DAVID LOWRY (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LOWRY
Last Name:BASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1400 N RITTER AVENUE
Mailing Address - Street 2:SUITE 370
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219
Mailing Address - Country:US
Mailing Address - Phone:317-355-1144
Mailing Address - Fax:317-355-1155
Practice Address - Street 1:1400 N RITTER AVENUE
Practice Address - Street 2:SUITE 370
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219
Practice Address - Country:US
Practice Address - Phone:317-355-1144
Practice Address - Fax:317-355-1155
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01024955A207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C24332Medicare UPIN
IN077550BMedicare ID - Type Unspecified