Provider Demographics
NPI:1720005606
Name:SAFADI, RAMI (MD)
Entity Type:Individual
Prefix:
First Name:RAMI
Middle Name:
Last Name:SAFADI
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 1:1221 SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-3257
Mailing Address - Country:US
Mailing Address - Phone:989-953-5325
Mailing Address - Fax:
Practice Address - Street 1:1221 SOUTH DR
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858
Practice Address - Country:US
Practice Address - Phone:989-953-5325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRS0672372085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI300E676040OtherBLUE CROSS
MI1720005606Medicaid
MI300E676040OtherBLUE CROSS
MI1720005606Medicaid