Provider Demographics
NPI:1023178126
Name:ZAINUDDIN, SANIA (MD)
Entity type:Individual
Prefix:
First Name:SANIA
Middle Name:
Last Name:ZAINUDDIN
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 1:2486 NERREDIA ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-4807
Mailing Address - Country:US
Mailing Address - Phone:810-733-8830
Mailing Address - Fax:810-230-9916
Practice Address - Street 1:2486 NERREDIA ST
Practice Address - Street 2:SUITE E
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-4807
Practice Address - Country:US
Practice Address - Phone:810-733-8830
Practice Address - Fax:810-230-9916
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301069960208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4244434Medicaid
MI4244434Medicaid