Provider Demographics
NPI:1508613183
Name:BAZZI, YOUNES
Entity type:Individual
Prefix:
First Name:YOUNES
Middle Name:
Last Name:BAZZI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7801 MANOR ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1276
Mailing Address - Country:US
Mailing Address - Phone:313-506-3046
Mailing Address - Fax:313-429-9205
Practice Address - Street 1:7801 MANOR ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-1276
Practice Address - Country:US
Practice Address - Phone:313-506-3046
Practice Address - Fax:313-429-9205
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIE70045342000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company