Provider Demographics
NPI:1700381209
Name:SAMIMI, MOHAMMAD MAX (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:MAX
Last Name:SAMIMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 DELAWARE AVE SW APT S844
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-3977
Mailing Address - Country:US
Mailing Address - Phone:805-895-3509
Mailing Address - Fax:
Practice Address - Street 1:ACADEMIC INTERNAL MEDICINE CLINIC
Practice Address - Street 2:5333 MCAULEY DRIVE SUITE 4001
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197
Practice Address - Country:US
Practice Address - Phone:734-712-3980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-27
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program