Provider Demographics
NPI:1679747091
Name:SAIB ISTERABADI MD
Entity Type:Organization
Organization Name:SAIB ISTERABADI MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSCIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SAIB
Authorized Official - Middle Name:
Authorized Official - Last Name:ISTERABADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-635-3295
Mailing Address - Street 1:2750 MAIN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MARLETTE
Mailing Address - State:MI
Mailing Address - Zip Code:48453-1100
Mailing Address - Country:US
Mailing Address - Phone:989-635-3295
Mailing Address - Fax:989-635-7384
Practice Address - Street 1:1850 BOYNE RD
Practice Address - Street 2:
Practice Address - City:MARLETTE
Practice Address - State:MI
Practice Address - Zip Code:48453-9746
Practice Address - Country:US
Practice Address - Phone:989-635-3295
Practice Address - Fax:989-635-7384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISI034846208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0207634391OtherBCBSM
MI1086921Medicaid
MI0207364391OtherARIZONA PHYSICIANS
MI101285OtherGREAT LAKES HEALTH PLAN
MI01004157OtherHEALTH PLUS PARTNERS
MIP41410OtherBLUECARE NETWORK
MIP41410OtherBLUECARE NETWORK
MI0207364391OtherARIZONA PHYSICIANS