Mostafa S Sadry MD PC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MS044076 Issued in MI

Legal business name

MOSTAFA S SADRY MD PC

Practice address

2603 Electric Ave
Suite 2
Port Huron, MI 48060-6588

Phone

(810) 985-4100

Fax

(810) 985-8244

NPI assigned

Sep 23, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Mostafa Seied Sadry, MD

Title

Owner

Phone

(810) 985-4100

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285200000000",
    "number": "1982912002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2603 ELECTRIC AVE",
            "address_2": "SUITE 2",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606588",
            "telephone_number": "810-985-4100",
            "fax_number": "810-985-8244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 ELECTRIC AVE",
            "address_2": "SUITE 2",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606588",
            "telephone_number": "810-985-4100",
            "fax_number": "810-985-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSTAFA S SADRY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-23",
        "last_updated": "2010-09-23",
        "status": "A",
        "authorized_official_last_name": "SADRY",
        "authorized_official_first_name": "MOSTAFA",
        "authorized_official_middle_name": "SEIED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-985-4100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "MS044076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2118850",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Neurology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; 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.