Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 5901002116 | MI |
Y | 222Z00000X | Podiatrist | 5901002116 | MI |
NPI | 1033182365 |
---|---|
Provider Name | Dr. Ali M. Safiedine |
First Address | Dearborn, MI 48126-1301 |
Second Address | Dearborn, MI 48126-1301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 29/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4606471 13 | (05) | MI |
U98187 | (02) | MI |