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General NPI Number Information
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NPI Number | 1679861389
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Entity Type | Individual
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Provider Name | AMGAD MOHAMMED HALEEM AMIN M.D
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Gender | Male
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Dates
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Enumeration Date | 07/14/2011
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 55 FRUIT ST
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City | BOSTON
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State | MA
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Zip | 02114-2621
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Country | US
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Telephone | 617-724-9338
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Fax |
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Provider Business Mailing Address
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Address Line | 800 STANTON L YOUNG BLVD STE 3400
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5018
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Country | US
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Telephone | 405-271-4426
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Fax | 405-271-3074
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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 | 1017457
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | 1017457
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | PENDING
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License Number State | NY
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