Provider Demographics
NPI:1952304610
Name:AHMED, BASIL SEBRI (MD)
Entity Type:Individual
Prefix:DR
First Name:BASIL
Middle Name:SEBRI
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:1240 S CEDAR CREST BLVD
Practice Address - Street 2:STE 305
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6218
Practice Address - Country:US
Practice Address - Phone:610-402-9050
Practice Address - Fax:610-402-9081
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066239-L207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA065289Medicare ID - Type UnspecifiedGROUP PRACTICE #
PA0018790900001Medicaid
PAH45140Medicare UPIN