Healthcare Provider Details

I. General information

NPI: 1922449453
Provider Name (Legal Business Name): SARITA SAID-SAID M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2013
Last Update Date: 11/10/2021
Certification Date: 11/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 S WASHINGTON ST
MOSCOW ID
83843-3090
US

IV. Provider business mailing address

619 S WASHINGTON ST
MOSCOW ID
83843-3090
US

V. Phone/Fax

Practice location:
  • Phone: 208-813-7519
  • Fax: 208-813-7524
Mailing address:
  • Phone: 208-813-7519
  • Fax: 208-813-7524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD-60929696
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberM-14623
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License NumberMD-60929696
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License NumberA148145
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License NumberM-14623
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: