MEDICARE: DR. BASSAM BATARSE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	4301063517	MI
2	207R00000X	Internal Medicine Physician	35.127530	OH
3	207P00000X	Emergency Medicine Physician	35.127530	OH

General Provider Information

NPI Number	:	1124033790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BASSAM BATARSE MD

Provider Business Mailing Address
First Line	:	29348 MORNINGVIEW
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-4003
Country	:	US
Telephone Number	:	248-470-2299
Fax Number	:

Provider Business Practice Location Address
First Line	:	29348 MORNINGVIEW
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-4003
Country	:	US
Telephone Number	:	248-470-2299
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	09/16/2022

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