Individual
DR. OMAR BASHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
44405 WOODWARD AVE, PONTIAC, MI 48341-5023
(248) 858-3000
Mailing address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(313) 745-5146
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301104269
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/26/2013
Last updated
04/09/2020
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