Provider Demographics
NPI:1104909597
Name:SARA-HARRIS FAMILY CARE PC
Entity type:Organization
Organization Name:SARA-HARRIS FAMILY CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SAIF
Authorized Official - Middle Name:U
Authorized Official - Last Name:CHEEMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-218-5777
Mailing Address - Street 1:332 W. TIENKEN RD.
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306
Mailing Address - Country:US
Mailing Address - Phone:248-218-5777
Mailing Address - Fax:248-608-4663
Practice Address - Street 1:332 W. TIENKEN RD.
Practice Address - Street 2:SUITE B
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48306
Practice Address - Country:US
Practice Address - Phone:248-218-5777
Practice Address - Fax:248-608-4663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301058744207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4536161Medicaid
MI4536161Medicaid
MI0M89260Medicare ID - Type Unspecified