Healthcare Provider Details

I. General information

NPI: 1295193415
Provider Name (Legal Business Name): SAAD-WATERWORKS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2016
Last Update Date: 02/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21031 MICHIGAN AVE FLOOR 2
DEARBORN MI
48124-2339
US

IV. Provider business mailing address

21031 MICHIGAN AVE
DEARBORN MI
48124-2339
US

V. Phone/Fax

Practice location:
  • Phone: 313-216-0332
  • Fax: 313-216-0335
Mailing address:
  • Phone: 313-216-0332
  • Fax: 313-216-0335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. HUSSEIN A SAAD
Title or Position: PRESIDENT
Credential: MD
Phone: 313-277-6700