Organization
MOHAMAD BAZZI M D P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMAD HASSAN BAZZI M.D. (PRESIDENT)
(734) 844-5700
Entity
Organization
Contact information
Practice address
42680 FORD RD., CANTON, MI 48187
(734) 844-5700
(734) 844-5703
Mailing address
42680 FORD RD., CANTON, MI 48187
(734) 844-5700
(734) 844-5703
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
4301066396
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138185
CARE CHOICES
MI
01
—
16435
MCARE
MI
01
—
2408212402
BLUE CROSS BLUE SHIELD
MI
05
—
4566509
—
MI
01
—
7175546
AETNA
MI
Enumeration date
10/02/2006
Last updated
05/03/2010
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