Individual
NASAM MARY BACHURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22201 MOROSS RD STE 80, DETROIT, MI 48236-2169
(313) 343-4756
Mailing address
22201 MOROSS RD STE 80, GROSSE POINTE, MI 48236-2169
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4351050435
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
MI
Other
Enumeration date
01/30/2023
Last updated
02/21/2023
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