Provider Demographics
NPI:1841268554
Name:BASA, ARTURO S (MD)
Entity type:Individual
Prefix:
First Name:ARTURO
Middle Name:S
Last Name:BASA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 PEARL ROAD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130
Mailing Address - Country:US
Mailing Address - Phone:440-845-0900
Mailing Address - Fax:440-845-7355
Practice Address - Street 1:6900 PEARL ROAD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130
Practice Address - Country:US
Practice Address - Phone:440-845-0900
Practice Address - Fax:440-845-7355
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35033250B208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0227169Medicaid
OH0227169Medicaid
OHBA0367533Medicare PIN