Provider Demographics
NPI:1700680998
Name:HANAN BAZZI, MD PLLC
Entity type:Organization
Organization Name:HANAN BAZZI, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HANAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:BAZZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-663-0955
Mailing Address - Street 1:33111 FORD RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-1153
Mailing Address - Country:US
Mailing Address - Phone:313-663-0955
Mailing Address - Fax:313-789-1666
Practice Address - Street 1:33111 FORD RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-1153
Practice Address - Country:US
Practice Address - Phone:313-663-0955
Practice Address - Fax:313-789-1666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty