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Individual

DR. BASIL AZMI ABDULMUTI QANDIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9222 JOSEPH CAMPAU ST, SUITE A, HAMTRAMCK, MI 48212-4059
(313) 871-8900
(313) 871-8901
Mailing address
9222 JOSEPH CAMPAU ST, SUITE A, HAMTRAMCK, MI 48212-4059
(313) 871-8900
(313) 871-8901

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301087756
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0809505962
BCBS
MI
05
1720288749
MI
01
P00832043
RAILROAD MEDICARE
MI
Enumeration date
07/18/2007
Last updated
08/18/2010
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