Basic Information
Provider Information
NPI: 1962963744
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAYOOD
FirstName: SINAN
MiddleName: SHELLEY
NamePrefix:  
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Credential:  
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Mailing Information
Address1: 1 MEDICAL DR DEPT OF
Address2:  
City: LEBANON
State: NH
PostalCode: 037560001
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 200 HAWKINS DR
Address2:  
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3193567102
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/26/2019
LastUpdateDate: 07/01/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 07/01/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207RC0000XR-12369IAY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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