Provider Demographics
NPI:1912941477
Name:ALSAADI, ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:ALSAADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ALI
Other - Middle Name:
Other - Last Name:ALSAADI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:26206 W 12 MILE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1754
Mailing Address - Country:US
Mailing Address - Phone:248-200-3715
Mailing Address - Fax:248-200-3717
Practice Address - Street 1:24353 ORCHARD LAKE RD STE D
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-1917
Practice Address - Country:US
Practice Address - Phone:248-200-3715
Practice Address - Fax:248-200-3717
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAA082560207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MII50816OtherHAP
MI205326061OtherTAX ID
MI110F339630OtherBCBSM
MI1106356302OtherBCBS
MI17869OtherMCARE
MI157283OtherGREAT LAKES HEALTH PLAN
MI4883328Medicaid
MI110F339630OtherBCBSM
MI4883328Medicaid