Provider Demographics
NPI:1952507055
Name:ATASI, BASSEL H (MMD)
Entity Type:Individual
Prefix:DR
First Name:BASSEL
Middle Name:H
Last Name:ATASI
Suffix:
Gender:M
Credentials:MMD
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Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR
Mailing Address - Street 2:J2000
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:202 W. HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843
Practice Address - Country:US
Practice Address - Phone:517-234-6540
Practice Address - Fax:517-338-9083
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2024-02-14
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Provider Licenses
StateLicense IDTaxonomies
MI4301082562207R00000X, 208000000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI231324Medicare PIN
MI5170569Medicaid