Individual
DR. ELIEZER BASSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18101 OAKWOOD BLVD, EMERGENCY DEPT, DEARBORN, MI 48124-4089
(313) 593-8780
(313) 436-2864
Mailing address
38935 ANN ARBOR RD, CREDENTIALING DEPT, LIVONIA, MI 48150-3397
(734) 805-0488
(866) 250-6385
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301034815
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11271518
CAQH
MI
Enumeration date
05/30/2006
Last updated
11/08/2012
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