Provider Demographics
NPI:1235853680
Name:BAZZI, YOUSSEF (RPH)
Entity type:Individual
Prefix:DR
First Name:YOUSSEF
Middle Name:
Last Name:BAZZI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5725 MCMILLAN ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2432
Mailing Address - Country:US
Mailing Address - Phone:313-455-2256
Mailing Address - Fax:
Practice Address - Street 1:21321 KELLY RD STE 110
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-3214
Practice Address - Country:US
Practice Address - Phone:586-981-0966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302414526183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist