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General NPI Number Information
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NPI Number | 1164830956
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Entity Type | Individual
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Provider Name | SUMAIYA AMENA HOSSAIN MD
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Gender | Female
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Dates
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Enumeration Date | 07/24/2014
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Last Update Date | 04/22/2023
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Provider Practice Location Address
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Address Line | 1332 PROSPECT AVE
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City | CARO
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State | MI
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Zip | 48723-9288
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Country | US
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Telephone | 989-672-3147
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Fax |
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Provider Business Mailing Address
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Address Line | 3319 GREENFIELD RD # 157
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City | DEARBORN
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State | MI
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Zip | 48120-1212
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Country | US
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Telephone | 313-314-1342
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Fax | 313-789-1644
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 4301505755
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 56415
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 56415
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 4301505755
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License Number State | MI
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