Provider Demographics
NPI:1003832585
Name:AREF, AMR M (MD)
Entity Type:Individual
Prefix:
First Name:AMR
Middle Name:M
Last Name:AREF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19229 MACK AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236
Mailing Address - Country:US
Mailing Address - Phone:313-647-3100
Mailing Address - Fax:313-647-3111
Practice Address - Street 1:19229 MACK AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236
Practice Address - Country:US
Practice Address - Phone:313-647-3100
Practice Address - Fax:313-647-3111
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0584932085R0001X
MI43010584932085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4151907Medicaid
A13947Medicare UPIN
MIM90750001Medicare ID - Type Unspecified