Provider Demographics
NPI:1659410546
Name:YASMIN SAHUL, MD, PLLC
Entity Type:Organization
Organization Name:YASMIN SAHUL, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YASMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-733-5390
Mailing Address - Street 1:5039 VILLA LINDE PKWY
Mailing Address - Street 2:SUITE 31
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3450
Mailing Address - Country:US
Mailing Address - Phone:810-733-5390
Mailing Address - Fax:810-733-6090
Practice Address - Street 1:5039 VILLA LINDE PKWY
Practice Address - Street 2:SUITE 31
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3450
Practice Address - Country:US
Practice Address - Phone:810-733-5390
Practice Address - Fax:810-733-6090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301075119207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N86040Medicare ID - Type Unspecified
MIH72788Medicare UPIN