Provider Demographics
NPI:1275838591
Name:SAYED-AHMAD, FATIMA (PA-C)
Entity Type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:SAYED-AHMAD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19401 HUBBARD DR
Mailing Address - Street 2:EMERGENCY DEPT
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2641
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19401 HUBBARD DR
Practice Address - Street 2:EMERGENCY DEPT
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2641
Practice Address - Country:US
Practice Address - Phone:313-982-8261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601005896363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant