Provider Demographics
NPI:1104927102
Name:ASAKER, BAHIGE (DO)
Entity type:Individual
Prefix:
First Name:BAHIGE
Middle Name:
Last Name:ASAKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 PLEASANT STREET
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-5055
Mailing Address - Country:US
Mailing Address - Phone:508-586-7706
Mailing Address - Fax:508-580-4444
Practice Address - Street 1:1020 PLEASANT STREET
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-5055
Practice Address - Country:US
Practice Address - Phone:508-586-7706
Practice Address - Fax:508-580-4444
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA53845207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9700439Medicaid
J06025Medicare PIN
A58686Medicare UPIN