Provider Demographics
NPI:1477845618
Name:ABOU-RASS, BASHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:BASHAR
Middle Name:
Last Name:ABOU-RASS
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 1:4673 RAVINE DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48301-3640
Mailing Address - Country:US
Mailing Address - Phone:248-757-0255
Mailing Address - Fax:
Practice Address - Street 1:4673 RAVINE DR
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48301-3640
Practice Address - Country:US
Practice Address - Phone:248-757-0255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-06
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301049185204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM