Healthcare Provider Details

I. General information

NPI: 1497913743
Provider Name (Legal Business Name): AHMED ABDUL-HAMID BAZZI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30575 WOODWARD AVE
ROYAL OAK MI
48073-0980
US

IV. Provider business mailing address

30575 WOODWARD AVE
ROYAL OAK MI
48073-0980
US

V. Phone/Fax

Practice location:
  • Phone: 248-280-8550
  • Fax: 248-280-8571
Mailing address:
  • Phone: 248-280-8550
  • Fax: 248-280-8571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberD0073769
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number5101017312
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number5101017312
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: