Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | D0058397 | MD |
NPI | 1033174123 |
---|---|
Provider Name | Tapendu Basu |
First Address | Westminster, MD 21157-6003 |
Second Address | Westminster, MD 21157-6003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 09/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D10494 | (02) |