Provider Demographics
NPI:1194733469
Name:BAZZI, BILAL T (MD)
Entity type:Individual
Prefix:
First Name:BILAL
Middle Name:T
Last Name:BAZZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1447 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4727
Mailing Address - Country:US
Mailing Address - Phone:989-792-1895
Mailing Address - Fax:989-792-2235
Practice Address - Street 1:1447 N HARRISON ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-4727
Practice Address - Country:US
Practice Address - Phone:989-583-4220
Practice Address - Fax:989-583-4287
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301082349207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1020790OtherMCLAREN HEALTH PLAN
MI17787OtherMCARE
MICD3610 P00371413OtherMETRAHEALTH
MI01004039OtherHEALTHPLUS
MI080D410020OtherBCBS
MI4901364Medicaid
MI1021107OtherMHP
MI5713533OtherFIRST HEALTH
MI7601819OtherAETNA
MI1020790OtherHEALTH ADVANTAGE NETWORK
MI1021107OtherMHP
MIOM28430140Medicare ID - Type UnspecifiedMEDICARE