Provider Demographics
NPI:1275264830
Name:BAZZI, LAMA (PA-C)
Entity Type:Individual
Prefix:
First Name:LAMA
Middle Name:
Last Name:BAZZI
Suffix:
Gender:F
Credentials:PA-C
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:9015 JOSEPH CAMPAU ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-3726
Mailing Address - Country:US
Mailing Address - Phone:313-664-0777
Mailing Address - Fax:
Practice Address - Street 1:9015 JOSEPH CAMPAU ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3726
Practice Address - Country:US
Practice Address - Phone:313-664-0777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant