Provider Demographics
NPI:1962622860
Name:BASURA, GREGORY JOSEPH (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:JOSEPH
Last Name:BASURA
Suffix:
Gender:
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 LOTHROP ST STE 300
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2548
Mailing Address - Country:US
Mailing Address - Phone:734-277-6169
Mailing Address - Fax:
Practice Address - Street 1:203 LOTHROP ST STE 300
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2548
Practice Address - Country:US
Practice Address - Phone:734-277-6169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD486447207YX0901X
MI4301096145207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology