Provider Demographics
NPI:1841451580
Name:BASS, MICHAEL H (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:H
Last Name:BASS
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:PO BOX 5372
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-0372
Mailing Address - Country:US
Mailing Address - Phone:302-832-1545
Mailing Address - Fax:302-834-4863
Practice Address - Street 1:1941 LIMESTONE RD STE 120
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5424
Practice Address - Country:US
Practice Address - Phone:302-832-1545
Practice Address - Fax:302-834-4863
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD78215207RG0100X
DEC10012022207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology