Provider Demographics
NPI:1447786520
Name:ABOUSAMRA, ANDREA (DO)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:ABOUSAMRA
Suffix:
Gender:F
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DRIVE
Mailing Address - Street 2:SUITE J2000
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105
Mailing Address - Country:US
Mailing Address - Phone:412-246-6160
Mailing Address - Fax:
Practice Address - Street 1:IHA NEUROLOGY
Practice Address - Street 2:5333 MCAULEY DRIVE SUITE 6109
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197
Practice Address - Country:US
Practice Address - Phone:248-734-7121
Practice Address - Fax:734-623-2857
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-10
Last Update Date:2023-01-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI51510107022084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology