Provider Demographics
NPI:1023345782
Name:SAMI, SYED AIJAZ (MD)
Entity type:Individual
Prefix:DR
First Name:SYED
Middle Name:AIJAZ
Last Name:SAMI
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 1:3170 HALLMARK CT
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-2107
Mailing Address - Country:US
Mailing Address - Phone:989-439-9111
Mailing Address - Fax:989-401-3611
Practice Address - Street 1:3170 HALLMARK CT
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-2107
Practice Address - Country:US
Practice Address - Phone:989-439-9111
Practice Address - Fax:989-401-3611
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-17
Last Update Date:2021-11-24
Deactivation Date:2021-01-22
Deactivation Code:
Reactivation Date:2021-02-03
Provider Licenses
StateLicense IDTaxonomies
MI4301092959207X00000X, 208D00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice