Basic Information
| Provider Information | |||||||||
| NPI: | 1265704225 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ABDULBASIT | ||||||||
| FirstName: | MUHAMMAD | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD, FACP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | BASIT | ||||||||
| OtherFirstName: | ABDUL | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | MD, FACP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 783311 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191783311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4848844500 | ||||||||
| FaxNumber: | 4848840699 | ||||||||
| Practice Location | |||||||||
| Address1: | 2545 SCHOENERSVILLE RD | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4848849677 | ||||||||
| FaxNumber: | 4848849297 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2012 | ||||||||
| LastUpdateDate: | 12/11/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 56758-20 | WI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD457875 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | MD457875 | PA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.