Provider Demographics
NPI:1265762553
Name:ALEXANDER H. SACKEYFIO, M.D., P.C.
Entity type:Organization
Organization Name:ALEXANDER H. SACKEYFIO, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:H
Authorized Official - Last Name:SACKEYFIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-471-0785
Mailing Address - Street 1:23800 ORCHARD LAKE RD
Mailing Address - Street 2:104
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-2560
Mailing Address - Country:US
Mailing Address - Phone:248-471-0785
Mailing Address - Fax:248-471-1406
Practice Address - Street 1:23800 ORCHARD LAKE RD
Practice Address - Street 2:104
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-2560
Practice Address - Country:US
Practice Address - Phone:248-471-0785
Practice Address - Fax:248-471-1406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI102105905Medicaid
B42981Medicare UPIN
MI102105905Medicaid