John R Basarich, MD Valid NPI

Individual provider · Family Medicine Physician · Watertown, WI

NPI

1033178512

Type

Individual (Type 1)

Primary specialty

Family Medicine Physician (Family Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207Q00000X

License number

44987 (WI)

Sex

Male

Sole proprietor

No

Enumerated

2006-03-22

Last updated

2021-07-29