Individual
ALI BAZZY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
311 MACK AVE STE 64100, DETROIT, MI 48201-2466
(313) 832-0650
Mailing address
27483 DEQUINDRE RD STE 304, MADISON HTS, MI 48071-5715
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704295900
MI
363LF0000X
Family Nurse Practitioner
4704295900
MI
Other
Enumeration date
07/19/2017
Last updated
11/10/2020
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