Provider Demographics
NPI:1639210669
Name:SYED, MOHAMMED (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:
Last Name:SYED
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 1:1428 HIGHLAND MDWS
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-2064
Mailing Address - Country:US
Mailing Address - Phone:810-733-5921
Mailing Address - Fax:
Practice Address - Street 1:1201 FLUSHING RD
Practice Address - Street 2:SUITE 1
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-4730
Practice Address - Country:US
Practice Address - Phone:810-235-8532
Practice Address - Fax:810-235-8203
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301061253207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4349534Medicaid
N97100005Medicare PIN
ON38110Medicare ID - Type Unspecified
MIG18649Medicare UPIN