Healthcare Provider Details
I. General information
NPI: 1043428626
Provider Name (Legal Business Name): SASE PERSAUD MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
314 N MAIN ST
CLAWSON MI
48017-1525
US
IV. Provider business mailing address
2834 PHEASANT RING DR
ROCHESTER HILLS MI
48309-2857
US
V. Phone/Fax
- Phone: 124-857-7060
- Fax: 128-577-0601
- Phone: 124-857-7060
- Fax: 248-577-0601
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SASE
PERSAUD
Title or Position: OWNER
Credential:
Phone: 248-577-0600