Healthcare Provider Details

I. General information

NPI: 1740616804
Provider Name (Legal Business Name): MOHAMMAD AMIN ARIANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2013
Last Update Date: 09/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 BELLE MEADE ST
GROSSE POINTE SHORES MI
48236-1552
US

IV. Provider business mailing address

65 BELLE MEADE ST
GROSSE POINTE SHORES MI
48236-1552
US

V. Phone/Fax

Practice location:
  • Phone: 313-886-5685
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number4301032057
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: