Provider Demographics
NPI:1215026422
Name:SACKEYFIO, ALEXANDER HANMAH (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:HANMAH
Last Name:SACKEYFIO
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 1:23800 ORCHARD LAKE RD
Mailing Address - Street 2:SUITE #104
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-2561
Mailing Address - Country:US
Mailing Address - Phone:248-471-0785
Mailing Address - Fax:248-471-1406
Practice Address - Street 1:23800 ORCHARD LAKE RD
Practice Address - Street 2:SUITE #104
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-2560
Practice Address - Country:US
Practice Address - Phone:248-471-0785
Practice Address - Fax:248-471-1406
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010377182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI06304992OtherBCBSM
MIB42981Medicare UPIN
MI06304992OtherBCBSM