Provider Demographics
NPI:1467442038
Name:OSAMA, SAYED (MD)
Entity Type:Individual
Prefix:
First Name:SAYED
Middle Name:
Last Name:OSAMA
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 1:2602 S SHORE DR
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-3510
Mailing Address - Country:US
Mailing Address - Phone:810-347-8127
Mailing Address - Fax:
Practice Address - Street 1:2486 NERREDIA ST
Practice Address - Street 2:SUITE E
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-4807
Practice Address - Country:US
Practice Address - Phone:810-230-9901
Practice Address - Fax:810-230-9916
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301070316174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI341390810Medicaid
MI341390810Medicaid
MIG57619Medicare UPIN