Provider Demographics
NPI:1588768642
Name:OMAR, SAID ABDEL-RAZIK (MD)
Entity type:Individual
Prefix:DR
First Name:SAID
Middle Name:ABDEL-RAZIK
Last Name:OMAR
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:B240 LIFE SCIENCES BLDG
Mailing Address - Street 2:DEPARTMENT OF PEDIATRICS AND HUMAN DEVELOPMENT
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824
Mailing Address - Country:US
Mailing Address - Phone:517-355-3308
Mailing Address - Fax:
Practice Address - Street 1:1215 E MICHIGAN AVE
Practice Address - Street 2:NEONATOLOGY UNIT
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1811
Practice Address - Country:US
Practice Address - Phone:517-364-2670
Practice Address - Fax:517-364-3994
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010628532080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3043440Medicaid
MIF95797Medicare UPIN
MI3043440Medicaid