Provider Demographics
NPI:1659688828
Name:KAZI, AMEENA (MD)
Entity Type:Individual
Prefix:
First Name:AMEENA
Middle Name:
Last Name:KAZI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 WALTON BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-1779
Mailing Address - Country:US
Mailing Address - Phone:248-650-1800
Mailing Address - Fax:248-650-1856
Practice Address - Street 1:1605 DAVISON AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48238
Practice Address - Country:US
Practice Address - Phone:313-865-6770
Practice Address - Fax:313-447-2627
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301068478207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine