Provider Demographics
NPI:1831158153
Name:AL-SAIDI, NAZAR (MD)
Entity type:Individual
Prefix:
First Name:NAZAR
Middle Name:
Last Name:AL-SAIDI
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 1:802 W KING ST STE G
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-2100
Mailing Address - Country:US
Mailing Address - Phone:989-725-8124
Mailing Address - Fax:989-723-1205
Practice Address - Street 1:802 W KING ST STE G
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-2100
Practice Address - Country:US
Practice Address - Phone:989-725-8124
Practice Address - Fax:989-723-1205
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010775642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1831158153Medicaid
MI371474206OtherTAX IDENTIFICATION NUMBER
MI104552325Medicaid
MIH44394Medicare UPIN