Provider Demographics
NPI:1164443487
Name:DAROS, AMY J (DO)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:J
Last Name:DAROS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:PO BOX 887
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48480-0887
Mailing Address - Country:US
Mailing Address - Phone:810-230-0338
Mailing Address - Fax:810-230-0595
Practice Address - Street 1:5065 MILLER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1037
Practice Address - Country:US
Practice Address - Phone:810-230-0338
Practice Address - Fax:810-230-0595
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101012998207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4250600Medicaid
MI4250600Medicaid