Provider Demographics
NPI:1548281629
Name:SAADEH A SAADEH MD PC
Entity type:Organization
Organization Name:SAADEH A SAADEH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAADEH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAADEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-505-4661
Mailing Address - Street 1:PO BOX 3270
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86405-3270
Mailing Address - Country:US
Mailing Address - Phone:928-505-4661
Mailing Address - Fax:928-505-4699
Practice Address - Street 1:1851 MESQUITE AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-5677
Practice Address - Country:US
Practice Address - Phone:928-505-4661
Practice Address - Fax:928-505-4699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZDC9339OtherRAIL ROAD MEDICARE
AZZ83850Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER