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Individual

DR. BASSEM JAMIL BASHA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
15144 LEVAN RD, SUITE 44, LIVONIA, MI 48154-5027
(734) 779-2136
(734) 779-2155
Mailing address
15144 LEVAN RD, SUITE 44, LIVONIA, MI 48154-5027
(734) 779-2136
(734) 779-2155

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
4301052316
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4517166
MI
Enumeration date
05/16/2006
Last updated
06/25/2021
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