Provider Demographics
NPI:1376227744
Name:SAIDI, SAM MICHAEL
Entity Type:Individual
Prefix:
First Name:SAM
Middle Name:MICHAEL
Last Name:SAIDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12308 OLD CANAL RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-6226
Mailing Address - Country:US
Mailing Address - Phone:240-529-7966
Mailing Address - Fax:
Practice Address - Street 1:9096 REXIS AVE
Practice Address - Street 2:
Practice Address - City:PERRY HALL
Practice Address - State:MD
Practice Address - Zip Code:21128-9021
Practice Address - Country:US
Practice Address - Phone:443-453-2031
Practice Address - Fax:443-216-7397
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty