Bashyam Iyengar MD

NPI 1205137403 - Family Medicine - 207Q00000X

NPI Details
NPI 1205137403
Gender Male
Enumeration Date 11/04/2010
Last Updated 05/22/2014
Entity Type Individual
Active Over 6 years ago
Practice Location
1760 EDGEWOOD AVE W STE B
SUITE B
JACKSONVILLE FL, 32208-7209, US
Phone (904) 358-8480
Fax (904) 358-8460
Business Location
1760 EDGEWOOD AVE W STE B
SUITE B
JACKSONVILLE FL, 32208-7209, US
Phone (904) 358-8480
Fax (904) 358-8460
Toxanomy
Taxonomy Code 207Q00000X
License State New Jersey
License Number 25MA08303600
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According to our database, Bashyam Iyengar MD NPI is 1205137403, taxonomy code is 207Q00000X and license number is 25MA08303600, license state is located at New Jersey. Bashyam Iyengar MD physically located at 1760 Edgewood Ave W Ste B, Jacksonville FL, 32208-7209. NPI Number Bashyam Iyengar MD has the Individual type.

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1205137403 NPI number is provided on an as is basis without warranty of any kind. 1205137403 is maintained by the National Plan & Provider Enumeration System. The contents of Bashyam Iyengar MD are for informational purposes only.