Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Baher Kamelishacc Boctor, MD

Individual provider Specialist · NPI 1699710129

Baher Kamelishacc Boctor, MD is an Anesthesiology in Detroit, Michigan. Qualified in 1987, 39 years ago. Practices with Northstar Anesthesia of Michigan III PLLC, a 567-clinician group. Licensed in Michigan.

Years since qualifying
39
Licensed in
MI
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3990 John R St
Detroit, MI 48201-2018
Phone: (313) 745-8521
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 4301056652 (MI)

Record details

NPI number1699710129
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 18, 2006
Last updated in NPPESSeptember 20, 2012
Mailing addressPo Box 64000, Dwr 641546, Detroit, MI 48264-0001

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Also practisesINTERVENTIONAL PAIN MANAGEMENT
Medical schoolOTHER
Graduated 1987 (39 years in practice)
Group practice Northstar Anesthesia Of Michigan Iii Pllc — 567 clinicians
Accepts Medicare assignment Not indicated

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