Provider Demographics
NPI:1548243835
Name:KAZZIHA, SAMER Y (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMER
Middle Name:Y
Last Name:KAZZIHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:37771 SCHOENHERR RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312
Mailing Address - Country:US
Mailing Address - Phone:586-698-1200
Mailing Address - Fax:586-978-1323
Practice Address - Street 1:37771 SCHOENHERR RD
Practice Address - Street 2:SUITE 101
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312
Practice Address - Country:US
Practice Address - Phone:586-698-1200
Practice Address - Fax:586-978-1323
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301060285207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3517303-10Medicaid
0E06345Medicare ID - Type Unspecified
MI3517303-10Medicaid