Individual
HISHAM S BASSIOUNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202
(313) 829-7974
Mailing address
5841 S MARYLAND AVE # MC1099, CHICAGO, IL 60637-1447
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
036075451
IL
2086S0129X
Vascular Surgery Physician
4301403406
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036075451
—
IL
Enumeration date
12/22/2006
Last updated
08/09/2018
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