Provider Demographics
NPI:1033182365
Name:SAFIEDINE, ALI M (DPM)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:M
Last Name:SAFIEDINE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7243 CHASE RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1301
Mailing Address - Country:US
Mailing Address - Phone:313-582-6222
Mailing Address - Fax:313-582-0166
Practice Address - Street 1:7243 CHASE RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-1301
Practice Address - Country:US
Practice Address - Phone:313-582-6222
Practice Address - Fax:313-582-0166
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002116213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4606471 13Medicaid
MIU98187Medicare UPIN
MI0N83370001Medicare PIN