Individual
RABIH MOUSSA BAZZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1537 MONROE ST, STE 100, DEARBORN, MI 48124-2842
(313) 359-2100
(313) 359-2104
Mailing address
1537 MONROE ST, STE 100, DEARBORN, MI 48124-2842
(313) 359-2100
(313) 359-2104
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301077565
MI
207RN0300X
Nephrology Physician
Primary
4301077565
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024084
MIDWEST HEALTH PLAN
—
01
—
05959549
ECFMG
—
05
—
104955561
—
MI
01
—
1106358722
BLUE CROSS BLUE SHIELD
MI
01
—
110H229590
BLUE CROSS BLUE SHIELD
MI
01
—
146976
GREAT LAKES HEALTH PLAN
—
01
—
5315018532
CONTROLLED SUBSTANCE
MI
01
—
8041
TOTAL HEALTH CARE
—
Enumeration date
08/09/2005
Last updated
03/07/2023
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