Provider Demographics
NPI:1013016880
Name:MOHAMMED WAEL AL-AMERI MD PC
Entity Type:Organization
Organization Name:MOHAMMED WAEL AL-AMERI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:WAEL
Authorized Official - Last Name:AL-AMERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-651-6460
Mailing Address - Street 1:75 BARCLAY CIR STE 205
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-5821
Mailing Address - Country:US
Mailing Address - Phone:248-651-6430
Mailing Address - Fax:248-650-1382
Practice Address - Street 1:75 BARCLAY CIR STE 205
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5821
Practice Address - Country:US
Practice Address - Phone:248-651-6430
Practice Address - Fax:248-650-1382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207RP1001X207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1831032Medicaid
MIA76974Medicare UPIN
MI0632054Medicare ID - Type UnspecifiedMEDICARE