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Individual
LUISA FERNANDA BAZAN
Active
Individual
LUISA FERNANDA BAZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301073791
MI
207RP1001X
Pulmonary Disease Physician
4301073791
MI
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
4301073791
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
481026010
—
MI
01
—
700H262220
BLUE CROSS-BLUE CROSS
—
01
—
LB073791
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
12/01/2006
Last updated
03/05/2021
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