Provider Demographics
NPI:1528170073
Name:BAYASI, MOHAMMED GHIATH (MD)
Entity type:Individual
Prefix:MR
First Name:MOHAMMED
Middle Name:GHIATH
Last Name:BAYASI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8220 S. SAGINAW ST. STE 800
Mailing Address - Street 2:SUITE 800
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-1890
Mailing Address - Country:US
Mailing Address - Phone:810-695-5864
Mailing Address - Fax:810-695-2412
Practice Address - Street 1:8220 S SAGINAW ST
Practice Address - Street 2:SUITE 800
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-1890
Practice Address - Country:US
Practice Address - Phone:810-695-5864
Practice Address - Fax:810-695-2412
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMB054535207RC0200X, 207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3413443Medicaid
MI3413443Medicaid
MI0B56209003Medicare ID - Type UnspecifiedMEDICARE
F10967Medicare UPIN