Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 23165 | NE |
N | 207RN0300X | Nephrologist | 36257 | IA |
NPI | 1013021815 |
---|---|
Provider Name | Dr. Khalid Bashir |
First Address | Omaha, NE 68124-2311 |
Second Address | Omaha, NE 68124-2323 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 26/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
098684 | MEDICARE PTAN (01) | NE |
41453 | MEDICARE PTAN (01) | IA |
G97255 | (02) | NE |