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Individual

MRS. RUTH E BAZICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1001 S RAISINVILLE RD, MONROE, MI 48161-9754
(734) 243-7340
(734) 243-5506
Mailing address
1001 S RAISINVILLE RD, MONROE, MI 48161-9754
(734) 243-7340
(734) 243-5506

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
4704074252
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3492124
MI
01
OE86008029
MEDICARE
MI
Enumeration date
09/26/2008
Last updated
09/26/2008
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