1700070760 NPI number — BASRI A SILA MD ULGAN I SILA MD PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700070760 NPI number — BASRI A SILA MD ULGAN I SILA MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BASRI A SILA MD ULGAN I SILA MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700070760
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/04/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1205 YORK ROAD
Provider Second Line Business Mailing Address:
SUITE 39
Provider Business Mailing Address City Name:
LUTHERVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21093
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-296-3113
Provider Business Mailing Address Fax Number:
410-296-6170

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1205 YORK ROAD
Provider Second Line Business Practice Location Address:
SUITE 39
Provider Business Practice Location Address City Name:
LUTHERVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21093
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-296-3113
Provider Business Practice Location Address Fax Number:
410-296-6170
Provider Enumeration Date:
09/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SILA
Authorized Official First Name:
ULGAN
Authorized Official Middle Name:
INAN
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
410-296-3113

Provider Taxonomy Codes

  • Taxonomy code: 2084P0804X , with the licence number:  D0010428 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207K00000X , with the licence number: D0010425 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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