Souad Bazzi

Individual provider Active NPI Other Technician · Sault Sainte Marie, MI

NPI 1699178012 · NPPES record last updated Jun 21, 2016

Key facts

NPI
1699178012
Entity type
Individual (NPI type 1)
Primary specialty
Other Technician 247200000X
Practice address
300 W Pier Dr
Apt. 216a
Sault Sainte Marie, MI 49783-1870
Phone
(313) 919-0347
NPI assigned
Sep 30, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X Yes

Addresses

Primary practice location

300 W Pier Dr
Apt. 216a
Sault Sainte Marie, MI 49783-1870

Mailing address

300 W Pier Dr
Apt. 216a
Sault Sainte Marie, MI 49783-1870
Phone (313) 919-0347

Other providers in Sault Sainte Marie, MI

All providers in Sault Sainte Marie, MI · Other Technician in Michigan

Sources for this page

Verify at the official NPI Registry.