Healthcare Provider Details

I. General information

NPI: 1194733469
Provider Name (Legal Business Name): BILAL T BAZZI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 04/23/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1447 N HARRISON ST
SAGINAW MI
48602-4727
US

IV. Provider business mailing address

1447 N HARRISON ST
SAGINAW MI
48602-4727
US

V. Phone/Fax

Practice location:
  • Phone: 989-583-4220
  • Fax: 989-583-4287
Mailing address:
  • Phone: 989-792-1895
  • Fax: 989-792-2235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301082349
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: