Healthcare Provider Details
I. General information
NPI: 1912229451
Provider Name (Legal Business Name): SALAH ELDIN ELSAID ELDOHIRI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/25/2010
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4800 S SAGINAW ST STE 1815
FLINT MI
48507-2677
US
IV. Provider business mailing address
4800 S SAGINAW ST STE 1815
FLINT MI
48507-2677
US
V. Phone/Fax
- Phone: 810-275-9152
- Fax: 810-213-0228
- Phone: 810-275-9152
- Fax: 810-213-0228
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 4301091833 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: