| Mostafa S Sadry Md Pc | |
|
2603 Electric Ave Suite 2 Port Huron MI 48060-6588 | |
| (810) 985-4100 | |
| (810) 985-8244 |
| Full Name | Mostafa S Sadry Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2603 Electric Ave, Port Huron, Michigan |
| Authorized Official Name and Position | Mostafa Seied Sadry (OWNER) |
| Authorized Official Contact | 8109854100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mostafa S Sadry Md Pc 2603 Electric Ave Suite 2 Port Huron MI 48060-6588 Ph: (810) 985-4100 | Mostafa S Sadry Md Pc 2603 Electric Ave Suite 2 Port Huron MI 48060-6588 Ph: (810) 985-4100 |
| NPI Number | 1982912002 |
|---|---|
| Provider Enumeration Date | 09/23/2010 |
| Last Update Date | 09/23/2010 |
| Medicare PECOS PAC ID | 3971765900 |
|---|---|
| Medicare Enrollment ID | O20120508000544 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982912002 | NPI | - | NPPES |
| 2118850 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | MS044076 (Michigan) | Primary |
| Provider Name | Mostafa S Sadry |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225133929 PECOS PAC ID: 3173785110 Enrollment ID: I20120508000642 |
| Provider Name | Payam Sadry |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558717611 PECOS PAC ID: 9234424060 Enrollment ID: I20210713000521 |
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