Healthcare Provider Details

I. General information

NPI: 1104289743
Provider Name (Legal Business Name): SHAMEL AMIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2790 HEALTH PKWY
MT PLEASANT MI
48858-6934
US

IV. Provider business mailing address

2790 HEALTH PKWY
MT PLEASANT MI
48858-6934
US

V. Phone/Fax

Practice location:
  • Phone: 989-779-5270
  • Fax: 989-779-5279
Mailing address:
  • Phone: 989-779-5270
  • Fax: 989-779-5279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number4301119326
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: