| Doctor Name: | MADHURI BASAK |
| NPI Number: | 1023128477 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RNC |
| License Number: | 12964 |
| Business Practice Address: | 4325 Grand Ave Duluth, MN - 558072730 |
| Business Phone Number: | 2187221497 |
| Business Fax Number: | 2187278646 |
| Mailing Address: | 4325 Grand Ave, DULUTH |
| State: | MN |
| Postal Code: | 558072730 |
| Phone Number: | 2187221497 |
| Fax Number: | 2187278646 |
| NPI Enumeration Date: | 08/30/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP2201X |
| License Number: | 12964 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Ambulatory Care |
| Taxonomy Definition: | |