Provider Demographics
NPI:1306892674
Name:BABAR SANAULLAH M.D. PLC
Entity type:Organization
Organization Name:BABAR SANAULLAH M.D. PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BABAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SANAULLAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-977-8000
Mailing Address - Street 1:2815 MICHIGAN ST NE
Mailing Address - Street 2:STE B
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-1266
Mailing Address - Country:US
Mailing Address - Phone:616-977-8000
Mailing Address - Fax:616-977-8002
Practice Address - Street 1:2815 MICHIGAN ST NE
Practice Address - Street 2:STE B
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-1266
Practice Address - Country:US
Practice Address - Phone:616-977-8000
Practice Address - Fax:616-977-8002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty