Individual
MARK MARLIN BAHOURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075
(248) 849-8519
Mailing address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-8519
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301111749
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1557829
—
MI
Enumeration date
06/01/2012
Last updated
06/29/2018
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