Provider Demographics
NPI:1750677233
Name:SYED, SANA (MD)
Entity Type:Individual
Prefix:DR
First Name:SANA
Middle Name:
Last Name:SYED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5820 N CANTON CENTER RD STE 186
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2651
Mailing Address - Country:US
Mailing Address - Phone:734-720-0976
Mailing Address - Fax:
Practice Address - Street 1:5820 N CANTON CENTER RD STE 186
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2651
Practice Address - Country:US
Practice Address - Phone:734-720-0976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301104936208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704297825Medicaid