Organization
SKA AT HOME VISITING DOCTOR PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NASIR AZ BASHIR (DIRECTOR)
(517) 990-2771
Entity
Organization
Contact information
Practice address
1302 N EATON ST STE A, ALBION, MI 49224-1041
(517) 990-2771
Mailing address
1302 N EATON ST STE A, ALBION, MI 49224-1041
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDED
BLUE CROSS OF MI
MI
05
—
PENDING
—
MI
Enumeration date
07/07/2011
Last updated
07/07/2011
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