MEDICARE: AMEEN JAMALEDDIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	4301098728	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417245721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMEEN JAMALEDDIN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 7892
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-7892
Country	:	US
Telephone Number	:	248-252-0065
Fax Number	:

Provider Business Practice Location Address
First Line	:	704 W HURON ST
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-4212
Country	:	US
Telephone Number	:	248-252-0065
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2011
Last Update Date	:	01/16/2022

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