Provider Demographics
NPI:1043481419
Name:JOSEPH S BASSETT, MD, PLC
Entity Type:Organization
Organization Name:JOSEPH S BASSETT, MD, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:S
Authorized Official - Last Name:BASSETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-982-5533
Mailing Address - Street 1:325 DUNSTON RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-3416
Mailing Address - Country:US
Mailing Address - Phone:248-689-1800
Mailing Address - Fax:248-251-0078
Practice Address - Street 1:18181 OAKWOOD BLVD
Practice Address - Street 2:SUITE # 102
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-5032
Practice Address - Country:US
Practice Address - Phone:313-982-5533
Practice Address - Fax:248-251-0078
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOSEPH S BASSETT, MD, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-13
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301024794208G00000X
MI208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4627023Medicaid
B43191Medicare UPIN
ON92160002Medicare PIN