Reda Ammar

Individual provider Active NPI Contractor · Dearborn, MI

NPI 1013047273 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1013047273
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
Practice address
10645 W Warren Ave Ste 251
Dearborn, MI 48126-1540
Phone
(313) 582-0004
Fax
(313) 582-0145
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Yes

Addresses

Primary practice location

10645 W Warren Ave Ste 251
Dearborn, MI 48126-1540

Mailing address

10645 W Warren Ave Ste 251
Dearborn, MI 48126-1540
Phone (313) 582-0004

Other providers in Dearborn, MI

All providers in Dearborn, MI · Contractor in Michigan

Sources for this page

Verify at the official NPI Registry.