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Organization

DEARBORN NURO CLINIC PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BASSAM MAAZ MD (PRESIDENT)
(313) 724-9584
Entity
Organization

Contact information

Practice address
25325 FORD RD, SUITE 100, DEARBORN, MI 48128-1086
(313) 724-0584
Mailing address
25325 FORD RD, SUITE 100, DEARBORN, MI 48128-1086
(313) 724-0584

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
4301053885
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1308248992
BLUE CROSS BLUE SHEILD OF MI
MI
05
4579561
MI
Enumeration date
05/05/2008
Last updated
05/05/2008
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