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CARLA A. BASTER D.O.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1831261015

Individual Registrant:
 CARLA A. BASTER D.O.
Gender: F
Sole Proprietor

Location and contact information for practice:
29 MINNEWAWA DR  TIMBERLAKE, OH 44095-1928 US
Tel: 440-479-1669  Fax: --

Contact information for business:
29 MINNEWAWA DR  TIMBERLAKE, OH 44095-1928 US
Tel: 440-479-1669  Fax: --

Registration Information:
NPI: 1831261015
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
OH34003592

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
LICENSE343003592OH01
0729733OH05




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