Healthcare Provider Details

I. General information

NPI: 1649095175
Provider Name (Legal Business Name): METRO HEALTH MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13479 NORTHLINE RD
SOUTHGATE MI
48195-1064
US

IV. Provider business mailing address

13479 NORTHLINE RD
SOUTHGATE MI
48195-1064
US

V. Phone/Fax

Practice location:
  • Phone: 313-663-6502
  • Fax:
Mailing address:
  • Phone: 313-663-6502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SAEED A BAZZI
Title or Position: AGENT
Credential: DO
Phone: 313-663-6502