Provider Demographics
NPI:1437286341
Name:AMAL OMRAN MD PC
Entity Type:Organization
Organization Name:AMAL OMRAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:OMRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-570-2394
Mailing Address - Street 1:35600 CENTRAL CITY PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-2046
Mailing Address - Country:US
Mailing Address - Phone:734-458-3330
Mailing Address - Fax:734-458-3331
Practice Address - Street 1:35600 CENTRAL CITY PKWY STE 103
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-2046
Practice Address - Country:US
Practice Address - Phone:734-458-3330
Practice Address - Fax:734-458-3331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301079605207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1144355934OtherNPI
MI0P23950Medicare PIN
MI1144355934OtherNPI