Provider Demographics
NPI:1811254394
Name:MITRI, SAMI HANNAH (DO)
Entity type:Individual
Prefix:DR
First Name:SAMI
Middle Name:HANNAH
Last Name:MITRI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:3955 PATIENT CARE DR STE A
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-4271
Mailing Address - Country:US
Mailing Address - Phone:517-374-7600
Mailing Address - Fax:517-374-1126
Practice Address - Street 1:7700 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2602
Practice Address - Country:US
Practice Address - Phone:303-730-8900
Practice Address - Fax:303-738-7755
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2020-12-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101020079207R00000X
CODR.0061321208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist