# BASEL A BRIKHO MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750548392
- **Authorized official:** BASEL A BRIKHO MD (OWNER)
- **Authorized official phone:** (248) 557-4443

## Contact information

- **Practice address:** 18211 W 12 MILE RD, LATHRUP VILLAGE, MI 48076-2641
- **Practice address phone:** (248) 557-4443
- **Practice address fax:** (248) 557-0573
- **Mailing address:** 18211 W 12 MILE RD, LATHRUP VILLAGE, MI 48076-2641
- **Mailing address phone:** (248) 557-4443
- **Mailing address fax:** (248) 557-0573

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 05/21/2008
- **Last updated:** 07/09/2008