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NPI 1699185280

NPI 1699185280 : RACHEL BASS DO : GRAND RAPIDS, MI

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General NPI Number Information
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    NPI Number           |    1699185280
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    Entity Type          |    Individual 
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    Provider Name        |    RACHEL BASS DO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/05/2014
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    Last Update Date     |    07/29/2025
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Provider Practice Location Address
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    Address Line         |    35 MICHIGAN ST NE STE 3003 
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    City                 |    GRAND RAPIDS
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    State                |    MI
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    Zip                  |    49503-2528
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    Country              |    US
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    Telephone            |    616-267-2500
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    100 MICHIGAN ST NE # MC845 
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    City                 |    GRAND RAPIDS
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    State                |    MI
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    Zip                  |    49503-2560
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2084N0402X
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    Taxonomy Name        |    Neurology with Special Qualifications in Child Neurology Physician
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    License Number       |    5101028767
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    License Number State |    MI
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Taxonomy #2
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    Taxonomy Code        |    2084N0008X
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    Taxonomy Name        |    Neuromuscular Medicine (Psychiatry & Neurology) Physician
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    License Number       |    5101028767
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    License Number State |    MI
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