Provider Demographics
NPI:1407826233
Name:BASU, ASHISH KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:ASHISH
Middle Name:KUMAR
Last Name:BASU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:930 FRANKLIN ST SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4312
Mailing Address - Country:US
Mailing Address - Phone:256-539-4080
Mailing Address - Fax:256-539-4099
Practice Address - Street 1:2424 DANVILLE RD SW
Practice Address - Street 2:SUITE L
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-4280
Practice Address - Country:US
Practice Address - Phone:256-351-0688
Practice Address - Fax:256-353-8894
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL22653207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL112957Medicaid
TN4041982OtherBCBS
AL510-49222OtherBCBS
AL112956Medicaid
AL051509636Medicaid
AL112949Medicaid
25-10769OtherUNITED HEALTHCARE
AL515-98439OtherBCBS
AL515-98440OtherBCBS
AL515-98442OtherBCBS
AL510-49221OtherBCBS
AL112943Medicaid
AL112953Medicaid
AL515-98443OtherBCBS
AL51509636OtherBCBS
060068573OtherRAILROAD MEDICARE
AL112947Medicaid
4469236OtherAETNA
AL515-98440OtherBCBS
25-10769OtherUNITED HEALTHCARE
AL510-49221OtherBCBS