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General NPI Number Information
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NPI Number | 1528292166
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Entity Type | Individual
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Provider Name | MICHAEL HAESSAM AMINI MD
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Gender | Male
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Dates
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Enumeration Date | 05/12/2009
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 2400 MARYLAND RD STE 20
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City | WILLOW GROVE
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State | PA
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Zip | 19090-1732
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Country | US
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Telephone | 800-321-9999
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Fax | 267-479-1321
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Provider Business Mailing Address
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Address Line | 833 CHESTNUT ST STE 520
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4430
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Country | US
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Telephone | 609-677-7003
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Fax | 267-479-1321
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 123520
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 51015
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | MD489621
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD489621
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License Number State | PA
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