Healthcare Provider Details
I. General information
NPI: 1780884635
Provider Name (Legal Business Name): ALTAMASH A AMIN MD PLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/19/2007
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
506 N FRANKLIN ST
FRANKENMUTH MI
48734-1000
US
IV. Provider business mailing address
2233 N CENTER RD
SAGINAW MI
48603-3730
US
V. Phone/Fax
- Phone: 989-652-9410
- Fax: 989-652-9132
- Phone: 989-793-4420
- Fax: 989-793-8577
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 4301062214 |
| License Number State | MI |
VIII. Authorized Official
Name:
ALTAMASH
A
AMIN
Title or Position: OWNER
Credential: MD
Phone: 989-793-4420