Provider Demographics
NPI:1912447699
Name:NORTH SAGINAW PRIMARY CARE, PLLC
Entity Type:Organization
Organization Name:NORTH SAGINAW PRIMARY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AWAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:AZIEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-785-1121
Mailing Address - Street 1:4250 N SAGINAW ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48505-5332
Mailing Address - Country:US
Mailing Address - Phone:810-785-1121
Mailing Address - Fax:810-785-3850
Practice Address - Street 1:4250 N SAGINAW ST
Practice Address - Street 2:SUITE A
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48505-5332
Practice Address - Country:US
Practice Address - Phone:810-785-1121
Practice Address - Fax:810-785-3850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301097557261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0Medicaid
MI0Medicare PIN
MI0Medicaid