Mikell, Charles Bazemore

Mikell, Charles Bazemore is an individual health care provider with primary practice located at Hsc T12 Room 080, Stony Brook NY 11794-8122. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Neurological Surgery. Allopathic & Osteopathic Physicians / Neurological Surgery is his primary health care specialty. Mikell, Charles Bazemore can be contacted via phone (631) 444-1116.

Contact Information

Primary practice address
Hsc T12 Room 080 Stony Brook NY 11794-8122
Phone: (631) 444-1116
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X TP008 Kentucky
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 273606 New York

Profile Details

NPI number 1124254917
LBN Legal business name Mikell, Charles Bazemore
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2009
Last updated Sep 27th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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