Provider Demographics
NPI:1972573681
Name:SAEED, SAJJAD (MD)
Entity Type:Individual
Prefix:
First Name:SAJJAD
Middle Name:
Last Name:SAEED
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 1:2615 ELECTRIC AVE
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-6575
Mailing Address - Country:US
Mailing Address - Phone:810-990-8222
Mailing Address - Fax:810-937-5592
Practice Address - Street 1:2615 ELECTRIC AVE
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-6575
Practice Address - Country:US
Practice Address - Phone:810-990-8222
Practice Address - Fax:810-937-5592
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301074253207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4739709Medicaid
5315009029OtherCONTROLLED SUBSTANCE
05680723OtherECFMG
I 18875Medicare UPIN
N71040012Medicare ID - Type Unspecified