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1730719139
MATTHEW SAMUELS BASHAM
SAGINAW, MI
NPI
1730719139
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: MI 4704286451)
Enumeration Date
2020-01-24
Last Update Date
2023-04-17
Business Address
MATTHEW SAMUELS BASHAM NP-C
4760 FASHION SQUARE BLVD STE L-1
SAGINAW, MI 48604-2620
Phone number: 989-282-4003
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Mailing Address
MATTHEW SAMUELS BASHAM NP-C
801 ROSEHILL RD
JACKSON, MI 49202-1762
Phone number: 517-212-2008
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