Provider Demographics
NPI:1083823835
Name:MID-MICHIGAN BEHAVIORAL HEALTH, PC
Entity Type:Organization
Organization Name:MID-MICHIGAN BEHAVIORAL HEALTH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAZAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:AL-SAIDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-725-8124
Mailing Address - Street 1:802 W KING ST STE G
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-2100
Mailing Address - Country:US
Mailing Address - Phone:989-725-8124
Mailing Address - Fax:989-723-1205
Practice Address - Street 1:802 W KING ST STE G
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-2100
Practice Address - Country:US
Practice Address - Phone:989-725-8124
Practice Address - Fax:989-723-1205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1083823835Medicaid
MI2607810162OtherBCBSM
MI0N84560Medicare Oscar/Certification
H44394Medicare UPIN