Provider Demographics
NPI:1942410667
Name:SADAH, ABDULMALEK (MD)
Entity type:Individual
Prefix:DR
First Name:ABDULMALEK
Middle Name:
Last Name:SADAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7715 GILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-3771
Mailing Address - Country:US
Mailing Address - Phone:419-454-1880
Mailing Address - Fax:
Practice Address - Street 1:43000 W 9 MILE RD STE 207
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-4132
Practice Address - Country:US
Practice Address - Phone:888-366-3907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301119245207R00000X
OH35.1258202084P0800X, 2084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201058700Medicaid
OH0128401Medicaid
IN201058700Medicaid
INM400075366Medicare PIN