Organization
SAI K. SISTA MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAI SISTA MD (OWNER PHYSICIAN)
(248) 344-0400
Entity
Organization
Contact information
Practice address
44000 W 12 MILE RD, SUITE 212, NOVI, MI 48377-2644
(248) 344-0400
(248) 347-8215
Mailing address
44000 W 12 MILE RD, SUITE 212, NOVI, MI 48377-2644
(248) 344-0400
(248) 347-8215
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4301034917
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100F338440
BC GROUP
MI
05
—
1932141306
—
MI
01
—
DQ4870
RAILROAD MEDICARE
MI
Enumeration date
06/12/2006
Last updated
12/08/2011
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