Basic Information
Provider Information
NPI: 1073892626
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BASHIR
FirstName: BABAR
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 909 WALNUT ST
Address2: 2ND FLOOR
City: PHILADELPHIA
State: PA
PostalCode: 191075211
CountryCode: US
TelephoneNumber: 2159557000
FaxNumber: 2155037007
Practice Location
Address1: 909 WALNUT ST
Address2: 2ND FLOOR
City: PHILADELPHIA
State: PA
PostalCode: 191075211
CountryCode: US
TelephoneNumber: 2159557000
FaxNumber: 2155037007
Other Information
ProviderEnumerationDate: 08/15/2011
LastUpdateDate: 09/03/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/03/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMT198506PAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XMD452546PAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RX0202XMD452546PAY Allopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology

No ID Information.


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