Provider Demographics
NPI:1164616629
Name:LINA SAKR MDPC
Entity Type:Organization
Organization Name:LINA SAKR MDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COPENY
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:810-720-2900
Mailing Address - Street 1:1380 COOLIDGE HWY
Mailing Address - Street 2:STE # 110
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-7069
Mailing Address - Country:US
Mailing Address - Phone:248-288-5700
Mailing Address - Fax:248-288-4256
Practice Address - Street 1:1380 COOLIDGE HWY
Practice Address - Street 2:STE # 110
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-7069
Practice Address - Country:US
Practice Address - Phone:248-288-5700
Practice Address - Fax:248-288-4256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILS058222207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI207R00000XOtherTAXONOMY
MILS058222OtherLICENSE
MILS058222OtherLICENSE
MI0829089Medicare PIN