Provider Demographics
NPI:1124033790
Name:BATARSE, BASSAM (MD)
Entity Type:Individual
Prefix:DR
First Name:BASSAM
Middle Name:
Last Name:BATARSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29348 MORNINGVIEW
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-4003
Mailing Address - Country:US
Mailing Address - Phone:248-470-2299
Mailing Address - Fax:
Practice Address - Street 1:29348 MORNINGVIEW
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-4003
Practice Address - Country:US
Practice Address - Phone:248-470-2299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301063517207R00000X
OH35.127530207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine