Healthcare Provider Details

I. General information

NPI: 1124095971
Provider Name (Legal Business Name): BRIAN ALBERT AMEEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 FASHION SQUARE BLVD. SUITE 201 (PRIVATE OFFICE 210)
SAGINAW MI
48603
US

IV. Provider business mailing address

4200 FASHION SQUARE BLVD. SUITE 201 (PRIVATE OFFICE 210)
SAGINAW MI
48603
US

V. Phone/Fax

Practice location:
  • Phone: 917-634-5311
  • Fax: 888-815-3583
Mailing address:
  • Phone: 917-634-5311
  • Fax: 888-815-3583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number32110
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number32110
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: