Provider Demographics
NPI:1740242759
Name:SAMIULLAH H SAYYID MD PC
Entity Type:Organization
Organization Name:SAMIULLAH H SAYYID MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMIULLAH
Authorized Official - Middle Name:HABIB
Authorized Official - Last Name:SAYYID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-733-5522
Mailing Address - Street 1:1085 PROFESSIONAL DR
Mailing Address - Street 2:STE G2
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3636
Mailing Address - Country:US
Mailing Address - Phone:810-733-5522
Mailing Address - Fax:810-733-8010
Practice Address - Street 1:1085 PROFESSIONAL DR
Practice Address - Street 2:STE G2
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3636
Practice Address - Country:US
Practice Address - Phone:810-733-5522
Practice Address - Fax:810-733-8010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301058555207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3295887Medicaid
MI3295887Medicaid
MIOM06231Medicare ID - Type Unspecified