Provider Demographics
NPI:1932376845
Name:SYED PHYSICIAN SERVICES M D P C
Entity type:Organization
Organization Name:SYED PHYSICIAN SERVICES M D P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRIGITTE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHATZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-334-3230
Mailing Address - Street 1:947 BALDWIN DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-5625
Mailing Address - Country:US
Mailing Address - Phone:248-334-3230
Mailing Address - Fax:
Practice Address - Street 1:947 BALDWIN DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-5625
Practice Address - Country:US
Practice Address - Phone:248-334-3230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMS155989207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4393766Medicaid
MION41300Medicare PIN