Doctor Name: | BASIL MOHAMMED DUDAR |
NPI Number: | 1407804958 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 4301079856 |
Business Practice Address: | 24211 Little Mack Ave St Clair Shores, MI - 480801190 |
Business Phone Number: | 5864980440 |
Business Fax Number: | 5864980401 |
Mailing Address: | 24211 Little Mack Ave, ST CLAIR SHORES |
State: | MI |
Postal Code: | 480801190 |
Phone Number: | 5864980440 |
Fax Number: | 5864980401 |
NPI Enumeration Date: | 05/05/2006 |
NPI Last Update Date: | 06/26/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207RC0000X |
License Number: | 4301079856 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Internal Medicine |
Taxonomy Specialization: | Cardiovascular Disease |
Taxonomy Definition: | An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |