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Individual

BASIL OMAR ABDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
24224 JOY RD, SUITE 100, REDFORD, MI 48239-1215
(313) 561-9090
(313) 561-3646
Mailing address
24224 JOY RD, SUITE 100, REDFORD, MI 48239-1215
(313) 561-9090
(313) 561-3646

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301081899
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08-0950225-2
BCBS INDIVIDUAL PIN #
MI
01
080F334280
BCBSM
05
4896139/10
MI
01
700E012740
BCBS GROUP NUMBER
MI
Enumeration date
06/10/2006
Last updated
07/22/2016
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