Provider Demographics
NPI:1215063284
Name:SAYEG PLASTIC SURGERY CENTER PC
Entity type:Organization
Organization Name:SAYEG PLASTIC SURGERY CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AYOUB
Authorized Official - Middle Name:
Authorized Official - Last Name:SAYEG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-526-9090
Mailing Address - Street 1:1120 E LONG LAKE RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-4974
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6858 CAMBRIDGE CT
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-2964
Practice Address - Country:US
Practice Address - Phone:248-526-9090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4374359Medicaid
MI4374359Medicaid
MI0N49180Medicare PIN