MEDICARE: DR. RYAN SAAB M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	4301098941	MI
2	207P00000X	Emergency Medicine Physician	4301098941	MI

General Provider Information

NPI Number	:	1306128202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN SAAB M.D.

Provider Business Mailing Address
First Line	:	PO BOX 100
Second Line	:	INDEPENDENT EMERGENCY PHYSICIANS, P.C.
City	:	ROYAL OAK
State	:	MI
Zip	:	48068
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	37000 GRAND RIVER AVE STE 310
Second Line	:
City	:	FARMINGTON
State	:	MI
Zip	:	48335-2868
Country	:	US
Telephone Number	:	248-536-2127
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2011
Last Update Date	:	06/01/2021

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