Provider Demographics
NPI:1104409952
Name:DAWOOD, BASHAR JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:BASHAR
Middle Name:JOSEPH
Last Name:DAWOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18000 W 9 MILE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4020
Mailing Address - Country:US
Mailing Address - Phone:248-336-4000
Mailing Address - Fax:
Practice Address - Street 1:28001 HARPER AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-1561
Practice Address - Country:US
Practice Address - Phone:248-336-4000
Practice Address - Fax:248-336-9137
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-29
Last Update Date:2025-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301512861207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine