MEDICARE: DR. AMNA AZIZ MD

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	208000000X	Pediatrics Physician	4301506102	MI

General Provider Information

NPI Number	:	1588196620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMNA AZIZ MD

Provider Business Mailing Address
First Line	:	3332 W PARC GREEN ST
Second Line	:
City	:	HARVEY
State	:	LA
Zip	:	70058-7040
Country	:	US
Telephone Number	:	504-638-0530
Fax Number	:

Provider Business Practice Location Address
First Line	:	6639 N TELEGRAPH RD
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-4812
Country	:	US
Telephone Number	:	313-274-3123
Fax Number	:

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

Provider Enumeration Date	:	03/29/2017
Last Update Date	:	06/09/2022

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