Provider Demographics
NPI:1154521482
Name:KHAYYATA, SAID HAFEZ (MD)
Entity type:Individual
Prefix:
First Name:SAID
Middle Name:HAFEZ
Last Name:KHAYYATA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26901 BEAUMONT BLVD
Mailing Address - Street 2:SUITE 3D
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1861
Mailing Address - Fax:947-522-0307
Practice Address - Street 1:4815 ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2705
Practice Address - Country:US
Practice Address - Phone:915-215-4956
Practice Address - Fax:915-215-4770
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT3630207ZC0500X, 207ZP0102X
OH35-093393207ZI0100X, 207ZN0500X, 207ZP0007X, 207ZP0102X, 207ZP0104X, 207ZP0105X, 207ZB0001X, 207ZC0006X, 207ZC0500X
MI4301081938207ZP0102X, 207ZC0500X, 207ZC0006X, 207ZB0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZI0100XAllopathic & Osteopathic PhysiciansPathologyImmunopathology
No207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology
No207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic Pathology
No207ZP0104XAllopathic & Osteopathic PhysiciansPathologyChemical Pathology
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2936756Medicaid
OHKH4264781Medicare PIN
OHP00735155Medicare PIN