Basaly, Richard M

Basaly, Richard M is an individual health care provider with primary practice located at 86 W Underwood St , Orlando FL 32806-1110. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Basaly, Richard M can be contacted via phone (888) 912-3648.

Contact Information

Primary practice address
86 W Underwood St Orlando FL 32806-1110
Phone: (888) 912-3648
Fax: (321) 841-4085
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X LL31891 South Carolina
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 2016-02367 North Carolina
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X ME124898 Florida
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 2016-02367 North Carolina
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME124898 Florida

Profile Details

NPI number 1497983084
LBN Legal business name Basaly, Richard M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2009
Last updated Dec 12th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497983084 NPPES
South Carolina MEDICAID 318917
South Carolina MEDICAID 016490700
South Carolina MEDICAID RHC202
South Carolina MEDICAID GP4819

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