Healthcare Provider Details

I. General information

NPI: 1093001299
Provider Name (Legal Business Name): SAIF M FATTEH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SAIF M FATTEH MD

II. Dates (important events)

Enumeration Date: 06/26/2011
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2316 S CEDAR ST
LANSING MI
48910-3152
US

IV. Provider business mailing address

2843 E GRAND RIVER AVE # 282
EAST LANSING MI
48823-6722
US

V. Phone/Fax

Practice location:
  • Phone: 517-887-4302
  • Fax:
Mailing address:
  • Phone: 855-472-3300
  • Fax: 855-472-3300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number207N00000X
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301098808
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number1014051
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number4301098808
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: