Organization Active NPI

Syed Amouzegar, MD,PLLC

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1982771531
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4030032424 Issued in MI
Legal business name
SYED AMOUZEGAR, MD,PLLC
Practice address
16810 W Warren Ave
Detroit, MI 48228-3503
Phone
(313) 582-9520
Fax
(313) 582-9521
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Syed A Amouzegar, (M.D.,PLLC)
Title
Internal Medicine
Phone
(313) 582-9520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 4030032424 MI Primary

Addresses

Primary practice location

16810 W Warren Ave
Detroit, MI 48228-3503

Mailing address

16810 W Warren Ave
Detroit, MI 48228-3503
Phone (313) 582-9520

Other identifiers 2

IdentifierTypeStateIssuer
1108201102OtherMIBLUE CROSS
4504990MedicaidMI

National Provider Directory

National Provider Directory

Locations

16810 W Warren Ave
Detroit, MI 48228
Phone (313) 582-9520

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982771531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16810 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283503",
            "telephone_number": "313-582-9520",
            "fax_number": "313-582-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16810 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283503",
            "telephone_number": "313-582-9520",
            "fax_number": "313-582-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYED AMOUZEGAR, MD,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AMOUZEGAR",
        "authorized_official_first_name": "SYED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "INTERNAL MEDICINE",
        "authorized_official_telephone_number": "313-582-9520",
        "authorized_official_credential": "(M.D.,PLLC)"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4030032424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1108201102",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4504990",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.