Most Relevant Information
Provider Data
| NPI Number: | 1003638636 |
| Provider Name: | MOHAMED IBRAHIM BAZZI |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 5201013874 |
Most Important Dates
| Enumeration Date: | 10/25/2024 |
| Last Updated: | 10/25/2024 |
Provider Practice Location
3990 JOHN R ST
DETROIT
MI
48201
Practice Location Phone/Fax
| Phone: | 8103331822 |
| Fax: |
Provider Mailing Location
21740 HOMER ST
DEARBORN
MI
481272927
Provider Mailing Phone/Fax
| Phone: | 8103331822 |
| Fax: |