Bastakoti, Subash

Bastakoti, Subash is an individual health care provider with primary practice located at 2845 Greenbrier Rd , Green Bay WI 54311-6519. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Bastakoti, Subash can be contacted via phone (920) 288-8000.

Contact Information

Primary practice address
2845 Greenbrier Rd Green Bay WI 54311-6519
Phone: (920) 288-8000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301108025 Michigan
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 72088 Wisconsin

Profile Details

NPI number 1770967036
LBN Legal business name Bastakoti, Subash
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2015
Last updated Nov 22nd, 2021 - about 5 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 1770967036 NPPES
Wisconsin MEDICAID 100099224

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