Individual
DR. LEEDA BASHARDOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MHSS, FRCPC
Contact information
Practice address
1221 SIXTH ST STE 300, TRAVERSE CITY, MI 49684-2360
(231) 932-0640
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-5000
Taxonomy
Speciality
Code
Description
License number
State
2084A2900X
Neurocritical Care Physician
2022034380
MO
2084N0400X
Neurology Physician
4301512829
MI
2084V0102X
Vascular Neurology Physician
Primary
4301512829
MI
Other
Enumeration date
08/30/2022
Last updated
12/26/2024
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