Healthcare Provider Details

I. General information

NPI: 1003897562
Provider Name (Legal Business Name): MALAZ ALMSADDI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 01/18/2021
Certification Date: 01/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 S TELEGRAPH RD SUITE 200
BLOOMFIELD HILLS MI
48302-0288
US

IV. Provider business mailing address

2525 S TELEGRAPH RD SUITE 200
BLOOMFIELD HILLS MI
48302-0288
US

V. Phone/Fax

Practice location:
  • Phone: 248-451-1466
  • Fax: 248-451-1467
Mailing address:
  • Phone: 248-451-1466
  • Fax: 248-451-1467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number4301091349
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4301091349
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: