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NPI Code Detail

MEDICARE: AMC PRIMARY CARE & CONSULTANTS PLLC

MEDICARE: AMC PRIMARY CARE & CONSULTANTS PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356093462
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMC PRIMARY CARE & CONSULTANTS PLLC
Provider Business Mailing Address
First Line : 23850 VAN BORN RD
Second Line :
City : DEARBORN HTS
State : MI
Zip : 48125-2325
Country : US
Telephone Number : 313-578-1911
Fax Number :
Provider Business Practice Location Address
First Line : 23850 VAN BORN RD
Second Line :
City : DEARBORN HTS
State : MI
Zip : 48125-2325
Country : US
Telephone Number : 313-578-1911
Fax Number :
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : AMERA GOBAH
Credential :
Telephone Number : 313-578-1911
Provider Enumeration Date : 01/20/2022
Last Update Date : 01/20/2022

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Directions to “AMC PRIMARY CARE & CONSULTANTS PLLC ” Practice Location

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