Healthcare Provider Details
I. General information
NPI: 1548207145
Provider Name (Legal Business Name): AHDI A AMER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/01/2006
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3950 BEAUBIEN - 1ST FL CHILDRENS HOSPITAL MI AMBULATORY
DETROIT MI
48201
US
IV. Provider business mailing address
4201 ST. ANTOINE - UHC 5D MAILBOX 226 UNIVERSITY PEDIATRCIANS
DETROIT MI
48201-2153
US
V. Phone/Fax
- Phone: 313-832-8290
- Fax: 313-993-0081
- Phone: 313-745-4405
- Fax: 313-966-0665
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 4301064952 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: