Provider Demographics
NPI:1902193006
Name:ESSA, BASAD ALI (MD)
Entity Type:Individual
Prefix:
First Name:BASAD
Middle Name:ALI
Last Name:ESSA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3555 W 13 MILE RD STE N120
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6710
Practice Address - Country:US
Practice Address - Phone:855-863-8761
Practice Address - Fax:248-551-8190
Is Sole Proprietor?:No
Enumeration Date:2011-07-09
Last Update Date:2023-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010990902084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology