Bassel Bardan, MD | |
1216 Ryans Rd, Worthington, MN 56187-1722 | |
(507) 372-2921 | |
(507) 372-5789 |
Full Name | Bassel Bardan |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 1216 Ryans Rd, Worthington, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1831283456 | NPI | - | NPPES |
54A03BA | Other | MN | BCBS MPIN |
539817700 | Medicaid | MN | |
370010988 | Other | MN | RR MEDICARE |
1909333 | Medicaid | IA | |
120955 | Other | MN | UCARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 39465 (Minnesota) | Primary |
Entity Name | Avera Mckennan |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093262131 PECOS PAC ID: 0345157103 Enrollment ID: O20040109001102 |
Entity Name | Rural Health Care Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1215317375 PECOS PAC ID: 3476447541 Enrollment ID: O20150710000034 |
Mailing Address | Practice Location Address |
---|---|
Bassel Bardan, MD 1216 Ryans Rd, Worthington, MN 56187-1722 Ph: (507) 372-2921 | Bassel Bardan, MD 1216 Ryans Rd, Worthington, MN 56187-1722 Ph: (507) 372-2921 |
Mark F Ludes, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1216 Ryans Rd, Worthington, MN 56187 Phone: 507-372-2921 Fax: 507-372-5789 | |
Krzysztof Piotr Dygulski, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1216 Ryans Rd, Worthington, MN 56187 Phone: 507-372-2921 Fax: 507-372-5789 | |
Lisa K Gerdes, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 508 Tenth Street, Worthington, MN 56187 Phone: 507-372-2921 Fax: 507-372-1815 |