Basic Information
| Provider Information | |||||||||
| NPI: | 1699783340 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAEED | ||||||||
| FirstName: | AKHTER | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11040 N STATE ROAD 77 | ||||||||
| Address2: | |||||||||
| City: | HAYWARD | ||||||||
| State: | WI | ||||||||
| PostalCode: | 548433606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7159344321 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11040 N STATE ROAD 77 | ||||||||
| Address2: | |||||||||
| City: | HAYWARD | ||||||||
| State: | WI | ||||||||
| PostalCode: | 548433606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7159344321 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2006 | ||||||||
| LastUpdateDate: | 06/11/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 4301077306 | MI | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | 4301077306 | MI | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1699783340 | 05 | MI | MEDICAID | AS077306 | 01 | MI | BCBS | OTHER | 080185218 | 01 | MI | RR MEDICARE | OTHER |