Provider Demographics
NPI:1760495121
Name:ELMAHDI SAEED MD PC
Entity Type:Organization
Organization Name:ELMAHDI SAEED MD PC
Other - Org Name:E SAEEDMDPC
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DENEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-238-6565
Mailing Address - Street 1:2 HURLEY PLZ
Mailing Address - Street 2:SUITE 108
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-5903
Mailing Address - Country:US
Mailing Address - Phone:810-238-6565
Mailing Address - Fax:810-238-6565
Practice Address - Street 1:2 HURLEY PLZ
Practice Address - Street 2:SUITE 108
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-5903
Practice Address - Country:US
Practice Address - Phone:810-238-6565
Practice Address - Fax:810-238-6565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301024102207Q00000X
MI4301051893207R00000X, 208000000X
MI4301064228207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4582905Medicaid
MI4582914Medicaid
MION73090002Medicare ID - Type Unspecified4301024102
MION73090001Medicare ID - Type Unspecified4301051893
MI4582914Medicaid
MIA77880Medicare UPIN
MI4582905Medicaid