Healthcare Provider Details

I. General information

NPI: 1548798432
Provider Name (Legal Business Name): ISMAIL B. SENDI, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2017
Last Update Date: 10/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 JOLLY OAK RD
OKEMOS MI
48864-3546
US

IV. Provider business mailing address

2300 JOLLY OAK RD
OKEMOS MI
48864-3559
US

V. Phone/Fax

Practice location:
  • Phone: 517-679-2050
  • Fax: 517-679-2051
Mailing address:
  • Phone: 517-679-2050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JUILA SCHIAPPACASSE
Title or Position: DIRECTOR, HR AND CREDENTIALING
Credential: MPA
Phone: 248-620-6400