Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 5101017312 | MI |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | D0073769 | MD |
NPI | 1497913743 |
---|---|
Provider Name | Dr. Ahmed A Bazzi |
First Address | Detroit, MI 48201-2119 |
Second Address | Detroit, MI 48201-2119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2008 |
Last Update Date | 13/06/2013 |