Provider Demographics
NPI:1275234502
Name:ISMAIL B. SENDI MD, PC
Entity Type:Organization
Organization Name:ISMAIL B. SENDI MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SENDI
Authorized Official - Suffix:
Authorized Official - Credentials:JD, MBA
Authorized Official - Phone:800-395-3223
Mailing Address - Street 1:26545 AMERICAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-6115
Mailing Address - Country:US
Mailing Address - Phone:800-395-3223
Mailing Address - Fax:833-329-6632
Practice Address - Street 1:1200 N. TELEGRAPH ROAD
Practice Address - Street 2:BUILDING 32E
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341
Practice Address - Country:US
Practice Address - Phone:248-464-6363
Practice Address - Fax:248-457-5553
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ISMAIL B SENDI MD, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)