Provider Demographics
NPI:1316464019
Name:SAHEB, ALI RAZAK SALMAN (NP)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:RAZAK SALMAN
Last Name:SAHEB
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9711 E WALTERS DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-7611
Mailing Address - Country:US
Mailing Address - Phone:906-362-7571
Mailing Address - Fax:
Practice Address - Street 1:9711 E WALTERS DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-7611
Practice Address - Country:US
Practice Address - Phone:906-362-7571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704287046363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health