Provider Demographics
NPI:1629332689
Name:HUSSEIN A SAAD MD PC
Entity Type:Organization
Organization Name:HUSSEIN A SAAD MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ADAMEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-277-6700
Mailing Address - Street 1:21031 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2339
Mailing Address - Country:US
Mailing Address - Phone:313-277-6700
Mailing Address - Fax:313-277-2483
Practice Address - Street 1:21031 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2339
Practice Address - Country:US
Practice Address - Phone:313-277-6700
Practice Address - Fax:313-277-2483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-25
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301089927207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1629332689Medicaid