Provider Demographics
NPI:1417908930
Name:SAAD, TOM T (MD)
Entity Type:Individual
Prefix:DR
First Name:TOM
Middle Name:T
Last Name:SAAD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1535 GULL RD
Mailing Address - Street 2:MSB 015
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-1650
Mailing Address - Country:US
Mailing Address - Phone:269-226-6933
Mailing Address - Fax:269-226-6949
Practice Address - Street 1:1535 GULL RD
Practice Address - Street 2:MSB 015
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1650
Practice Address - Country:US
Practice Address - Phone:269-226-6933
Practice Address - Fax:269-226-6949
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2011-12-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301055215207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1417908930Medicaid
MI2856439-10Medicaid
MITS055215OtherBLUE CROSS BLUE SHIELD
MI104156663Medicaid
MIF29814Medicare UPIN
MI2856439-10Medicaid
MI1417908930Medicaid
MIMI1609039Medicare PIN