MEDICARE: MATTHEW LEONARD AMAN

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
1	363LG0600X	Gerontology Nurse Practitioner	4704293315	MI
2	363L00000X	Nurse Practitioner	4704293315	MI

General Provider Information

NPI Number	:	1366094435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW LEONARD AMAN

Provider Business Mailing Address
First Line	:	27483 DEQUINDRE RD STE 302
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-5715
Country	:	US
Telephone Number	:	248-967-7769
Fax Number	:	248-547-5696

Provider Business Practice Location Address
First Line	:	135 BARCLAY CIR STE 100
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-4599
Country	:	US
Telephone Number	:	248-852-2277
Fax Number	:	833-533-4924

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2019
Last Update Date	:	06/01/2026

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