Individual provider Active NPI

Aya Omar Saeb, MD

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1467765503
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301096412 Issued in MI
Practice address
21540 W 11 Mile Rd
Ste 200
Southfield, MI 48076-3843
Phone
(630) 935-3862
NPI assigned
Jul 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 4301096412 MI
Internal Medicine Physician 207R00000X AS3062508-51 MI
Internal Medicine Physician 207R00000X 4301096412 MI Primary

Addresses

Primary practice location

21540 W 11 Mile Rd
Ste 200
Southfield, MI 48076-3843

Mailing address

41472 Glade Rd
Canton, MI 48187-3770
Phone (630) 935-3862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301096412MIMDInternal Medicine Physician
AS3062508-51MIMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460505600000",
    "number": "1467765503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41472 GLADE RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873770",
            "telephone_number": "630-935-3862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21540 W 11 MILE RD",
            "address_2": "STE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763843",
            "telephone_number": "630-935-3862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAEB",
        "first_name": "AYA",
        "middle_name": "OMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-19",
        "last_updated": "2016-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "4301096412",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "AS3062508-51",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301096412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.