Provider Demographics
NPI:1114288446
Name:SAJEDA NUSRAT MD FAMILY MEDICINE PLLC
Entity Type:Organization
Organization Name:SAJEDA NUSRAT MD FAMILY MEDICINE PLLC
Other - Org Name:FOREMOST FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAJEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NUSRAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-249-4040
Mailing Address - Street 1:3310 SHATTUCK RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-3263
Mailing Address - Country:US
Mailing Address - Phone:989-249-4040
Mailing Address - Fax:989-249-4045
Practice Address - Street 1:3310 SHATTUCK RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-3263
Practice Address - Country:US
Practice Address - Phone:989-249-4040
Practice Address - Fax:989-249-4045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301079825207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty