Provider Demographics
NPI:1003897562
Name:ALMSADDI, MALAZ (MD)
Entity Type:Individual
Prefix:MR
First Name:MALAZ
Middle Name:
Last Name:ALMSADDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 S TELEGRAPH RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0288
Mailing Address - Country:US
Mailing Address - Phone:248-451-1466
Mailing Address - Fax:248-451-1467
Practice Address - Street 1:2525 S TELEGRAPH RD
Practice Address - Street 2:SUITE 200
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0288
Practice Address - Country:US
Practice Address - Phone:248-451-1466
Practice Address - Fax:248-451-1467
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010913492084S0012X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1003897562Medicaid
MIMI1972Medicare PIN
MI1003897562Medicaid