Organization
PROVIDERS TEK INC.
Active
Organization
PROVIDERS TEK INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOUSSA BAZZI MD (OWNER)
(313) 740-1111
Entity
Organization
Contact information
Practice address
4700 GREENFIELD RD # 2E, DEARBORN, MI 48126-4124
(734) 462-0340
Mailing address
PO BOX 1997, DEARBORN, MI 48121-1997
(313) 740-1111
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
4301105966
MI
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
01/17/2018
Last updated
11/11/2021
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