Provider Demographics
NPI:1134937394
Name:ALSUMIRI, SAHAR A
Entity type:Individual
Prefix:
First Name:SAHAR
Middle Name:A
Last Name:ALSUMIRI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 ABERDEEN ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3404
Mailing Address - Country:US
Mailing Address - Phone:313-247-5739
Mailing Address - Fax:
Practice Address - Street 1:1360 ABERDEEN ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3404
Practice Address - Country:US
Practice Address - Phone:313-247-5739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704350853363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily