Provider Demographics
NPI:1235973496
Name:SADIK, BALSAM
Entity type:Individual
Prefix:
First Name:BALSAM
Middle Name:
Last Name:SADIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3834 KNIGHTBRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-4531
Mailing Address - Country:US
Mailing Address - Phone:248-904-5655
Mailing Address - Fax:
Practice Address - Street 1:3834 KNIGHTBRIDGE CIR
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-4531
Practice Address - Country:US
Practice Address - Phone:248-904-5655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-22
Last Update Date:2024-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker