Individual
IBRAHIM M BASMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
22521 MICHIGAN AVENUE, DEARBORN, MI 48124
(313) 278-1515
Mailing address
7528 E MORROW CIR, DEARBORN, MI 48126-1644
(313) 300-5549
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302044664
MI
Other
Enumeration date
07/16/2018
Last updated
07/16/2018
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