Provider Demographics
NPI:1144496639
Name:BASINA, BHUVANESWARA RAJU (MD)
Entity type:Individual
Prefix:DR
First Name:BHUVANESWARA
Middle Name:RAJU
Last Name:BASINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BHUVANESWARA
Other - Middle Name:RAJU
Other - Last Name:BASINA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2931 VAN AKEN BLVD
Mailing Address - Street 2:APT#15
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-2244
Mailing Address - Country:US
Mailing Address - Phone:313-268-7073
Mailing Address - Fax:
Practice Address - Street 1:2931 VANAKEN BLVD
Practice Address - Street 2:APT # 15
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-4422
Practice Address - Country:US
Practice Address - Phone:313-268-7073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program