Provider Demographics
NPI:1154364354
Name:SAAD, GEORGE YACOUB (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:YACOUB
Last Name:SAAD
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 1:20526 PLYMOUTH RD STE C
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-1273
Mailing Address - Country:US
Mailing Address - Phone:313-272-9570
Mailing Address - Fax:313-272-9575
Practice Address - Street 1:20526 PLYMOUTH RD STE C
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-1273
Practice Address - Country:US
Practice Address - Phone:313-272-9570
Practice Address - Fax:313-272-9575
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIGS056809207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G21501Medicare UPIN