1700383049 NPI number — SAEED AMIN SAEED

Table of content: SAEED AMIN SAEED (NPI 1700383049)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700383049 NPI number — SAEED AMIN SAEED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAEED
Provider First Name:
SAEED
Provider Middle Name:
AMIN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SAEED
Provider Other First Name:
SAEED
Provider Other Middle Name:
AMIN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LOYAL LOCAL TRANSPOR
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1700383049
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/12/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1110 PARK DR APT 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND FORKS
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58201-6979
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
763-777-2838
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1517 CEDAR DR NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST GRAND FORKS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56721-3239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-777-2838
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/12/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 172A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 82-5113162 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".