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General NPI Number Information
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NPI Number | 1306010145
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Entity Type | Organization
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Legal Business Name | YAZDI N. AMARIA,M.D.,P.C.
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 05/27/2008
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Provider Practice Location Address
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Address Line | 111 S MONROE ST
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City | STURGIS
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State | MI
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Zip | 49091-1728
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Country | US
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Telephone | 269-651-3218
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Fax | 269-651-3219
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Provider Business Mailing Address
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Address Line | 111 S MONROE ST
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City | STURGIS
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State | MI
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Zip | 49091-1728
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Country | US
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Telephone | 269-651-3218
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Fax | 269-651-3219
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YAZDI N AMARIA
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Credential | M.D.
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Telephone | 269-651-3218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301049704
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License Number State | MI
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