Bastawros, Iman
Bastawros, Iman is an individual health care provider with primary practice located at 4441 Far Hills Ave , Kettering OH 45429-2405. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Bastawros, Iman can be contacted via phone (937) 298-7351.Contact Information
Primary practice address
4441 Far Hills Ave
Kettering OH 45429-2405
Phone: (937) 298-7351
Fax: (937) 298-9458
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 35.132323 | Ohio |
Profile Details
| NPI number | 1184677585 |
|---|---|
| LBN Legal business name | Bastawros, Iman |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 18th, 2006 |
| Last updated | Nov 19th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184677585 | NPPES |
| Kentucky | Other | 000000494990 | ANTHEM |
| Kentucky | MEDICAID | 64128341 | ANTHEM |
| Kentucky | MEDICAID | 2992141 | ANTHEM |
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