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NPI Code Detail

MEDICARE: SYED AMOUZEGAR, MD,PLLC

MEDICARE: SYED AMOUZEGAR, MD,PLLC
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
1207R00000XInternal Medicine Physician4030032424MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11108201102OTHERMIBLUE CROSS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982771531
Entity Type Code : Organization
Provider Name (Legal Business Name) : SYED AMOUZEGAR, MD,PLLC
Provider Business Mailing Address
First Line : 16810 W WARREN AVE
Second Line :
City : DETROIT
State : MI
Zip : 48228-3503
Country : US
Telephone Number : 313-582-9520
Fax Number : 313-582-9521
Provider Business Practice Location Address
First Line : 16810 W WARREN AVE
Second Line :
City : DETROIT
State : MI
Zip : 48228-3503
Country : US
Telephone Number : 313-582-9520
Fax Number : 313-582-9521
Authorized Official
Title or Position : INTERNAL MEDICINE
Name : SYED A AMOUZEGAR
Credential : (M.D.,PLLC)
Telephone Number : 313-582-9520
Provider Enumeration Date : 11/29/2006
Last Update Date : 08/22/2020

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