Provider Demographics
NPI:1225292568
Name:AL JAYYOUSI, BASHAR BT (MD)
Entity Type:Individual
Prefix:DR
First Name:BASHAR
Middle Name:BT
Last Name:AL JAYYOUSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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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:989-497-9395
Mailing Address - Fax:989-583-7173
Practice Address - Street 1:900 COOPER AVE
Practice Address - Street 2:SUITE 4100
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-5182
Practice Address - Country:US
Practice Address - Phone:989-497-9395
Practice Address - Fax:989-583-7173
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2021-03-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301109061207RC0000X, 207RI0011X, 207RI0011X
IA39551207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology