Provider Demographics
NPI:1215713086
Name:SAREINI, MARIAM M (PA-C)
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:M
Last Name:SAREINI
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:18000 W 9 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4009
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18463 LIVERNOIS AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-2254
Practice Address - Country:US
Practice Address - Phone:313-861-4400
Practice Address - Fax:313-861-5810
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2024-01-15
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant