Individual
MADELYN LORI BASTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(248) 536-2127
Mailing address
33333 W 12 MILE RD, FARMINGTON HILLS, MI 48334-3312
(248) 536-2127
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
10/11/2021
Last updated
01/21/2026
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