Individual
DR. BASEEM WAHAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22137 MICHIGAN AVE, DEARBORN, MI 48124-2204
(248) 387-9595
Mailing address
PO BOX 2044, DEARBORN, MI 48123-2044
(248) 387-9595
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1176
AZ
152W00000X
Optometrist
Primary
4901004506
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
727688
—
AZ
Enumeration date
01/25/2006
Last updated
11/07/2011
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