Individual
SAMIR BASATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 S CENTER ROAD, BLDG A, BURTON, MI 48509
(810) 742-3400
(810) 742-2534
Mailing address
1501 S CENTER ROAD, BLDG A, BURTON, MI 48509
(810) 742-3400
(810) 742-2534
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
SB057189
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02512351
BC
—
05
—
2690402
—
MI
Enumeration date
08/31/2006
Last updated
07/08/2007
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