Mohamad Bazzi M D P C

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

4301066396 Issued in MI

Legal business name

MOHAMAD BAZZI M D P C

Practice address

42680 Ford Rd.
Canton, MI 48187

Phone

(734) 844-5700

Fax

(734) 844-5703

NPI assigned

Oct 2, 2006

Last updated

May 3, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mohamad Hassan Bazzi, M.D.NPI 1497781447

Title

President

Phone

(734) 844-5700

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mohamad Hassan Bazzi, M.D., F.A.C.S.

  • Plastic Surgery Physician
  • Canton, MI
  • NPI 1497781447
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272844800000",
    "number": "1801989553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42680 FORD RD.",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "48187",
            "telephone_number": "734-844-5700",
            "fax_number": "734-844-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42680 FORD RD.",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "48187",
            "telephone_number": "734-844-5700",
            "fax_number": "734-844-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAMAD BAZZI M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2010-05-03",
        "status": "A",
        "authorized_official_last_name": "BAZZI",
        "authorized_official_first_name": "MOHAMAD",
        "authorized_official_middle_name": "HASSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-844-5700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "4301066396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "16435",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7175546",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2408212402",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "138185",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4566509",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Elizabeth Mitchell
• Sytriss Lasean Mitchell, LPN
• Subham Mitra, RN
• Francesca Leanne Mitrano
• Marrisa Modell
• Syeda Yasmeen Mohammad, PSY.D.LP
• Wisal S Mohd, RPH
• Momentum Care
• Mommy & Mentors Mihp, LLC
• Monica J Thomson, DO, PLLC

• Plastic Surgery Physician in Canton, MI
• Providers in Canton, MI by specialty
• Plastic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.