MEDICARE: OUSMAN KAMARA

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	363L00000X	Nurse Practitioner	F08180419	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	08180419	OTHER		NA
2	08180419	OTHER	MI	NA

General Provider Information

NPI Number	:	1932677614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OUSMAN KAMARA

Provider Business Mailing Address
First Line	:	18440 W 9 MILE RD
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48075-4034
Country	:	US
Telephone Number	:	313-414-6242
Fax Number	:

Provider Business Practice Location Address
First Line	:	26237 SOUTHFIELD RD
Second Line	:
City	:	LATHRUP VILLAGE
State	:	MI
Zip	:	48076-4546
Country	:	US
Telephone Number	:	313-898-4390
Fax Number	:

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

Provider Enumeration Date	:	11/11/2018
Last Update Date	:	11/11/2018

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Directions to “ OUSMAN KAMARA ” Practice Location

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