Basic Information
| Provider Information | |||||||||
| NPI: | 1205184181 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BASHIR | ||||||||
| FirstName: | FATHI | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | BASHIR | ||||||||
| OtherFirstName: | FATHI | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 5010 | ||||||||
| Address2: | |||||||||
| City: | MINOT | ||||||||
| State: | ND | ||||||||
| PostalCode: | 587025010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7018575650 | ||||||||
| FaxNumber: | 7018575031 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 BURDICK EXPY. W. | ||||||||
| Address2: | |||||||||
| City: | MINOT | ||||||||
| State: | ND | ||||||||
| PostalCode: | 587014406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7018575124 | ||||||||
| FaxNumber: | 7018573264 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/26/2012 | ||||||||
| LastUpdateDate: | 11/19/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 20547 | NH | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207LC0200X | 008450 | GA | N | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | 207LC0200X | 14491 | ND | N | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine |
No ID Information.