Provider Demographics
NPI:1407960453
Name:AL-HADIDI, SAMIR S (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:S
Last Name:AL-HADIDI
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:PO BOX 71066
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-0020
Mailing Address - Country:US
Mailing Address - Phone:248-844-2600
Mailing Address - Fax:248-844-0991
Practice Address - Street 1:1349 S ROCHESTER RD STE 210
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-3152
Practice Address - Country:US
Practice Address - Phone:248-844-2600
Practice Address - Fax:248-844-0991
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISA045286207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0635109OtherBCBSM
MI0500265Medicare ID - Type Unspecified
0635109OtherBCBSM