Healthcare Provider Details

I. General information

NPI: 1679115232
Provider Name (Legal Business Name): ISMAIL B. SENDI, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2019
Last Update Date: 10/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 10TH ST
PORT HURON MI
48060-4477
US

IV. Provider business mailing address

6549 TOWN CENTER DR STE A
CLARKSTON MI
48346-4824
US

V. Phone/Fax

Practice location:
  • Phone: 810-357-0760
  • Fax: 810-357-0761
Mailing address:
  • Phone: 248-620-6400
  • Fax: 248-620-6405

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: JULIA SCHIAPPACASSE
Title or Position: DIRECTOR, HUMAN RESOURCES
Credential: MPA
Phone: 248-620-6400