Provider Demographics
NPI:1033104393
Name:ESMAIL, IMU AMIRALI (MD)
Entity Type:Individual
Prefix:MR
First Name:IMU
Middle Name:AMIRALI
Last Name:ESMAIL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 E MICHIGAN AVE
Mailing Address - Street 2:SUITE 370
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-1800
Mailing Address - Country:US
Mailing Address - Phone:517-484-4451
Mailing Address - Fax:517-484-0291
Practice Address - Street 1:1200 E MICHIGAN AVE
Practice Address - Street 2:SUITE 370
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1800
Practice Address - Country:US
Practice Address - Phone:517-484-4451
Practice Address - Fax:517-484-0291
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301061579207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G48691Medicare UPIN