1437407483 NPI number — AMERICAN AMBULATORY PHYSICIANS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437407483 NPI number — AMERICAN AMBULATORY PHYSICIANS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN AMBULATORY PHYSICIANS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437407483
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/05/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11554 HIGHLAND RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARTLAND
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48353-2711
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-632-0086
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1785 W STADIUM BLVD
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
ANN ARBOR
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-995-8888
Provider Business Practice Location Address Fax Number:
734-316-2275
Provider Enumeration Date:
08/23/2012

Additional Information

Authorized Official

Authorized Official Last Name:
ALI
Authorized Official First Name:
NASIR
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
810-394-1300

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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