Amin Abu Khatir, M.D.
Individual provider Active NPI Family Medicine Physician · Detroit, MI
NPI 1992259832 · NPPES record last updated Jun 25, 2019
Key facts
- NPI
- 1992259832
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 4301116835 (MI)
- Practice address
- 22101 Moross Rd
Detroit, MI 48236-2148 - Phone
- (586) 777-2050
- NPI assigned
- Aug 9, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160817001009 | MI | Order and Referring Only - Family Practice |
2264727106 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301116835 | MI | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301116835 | MI | Yes |
Addresses
Primary practice location
22101 Moross Rd
Detroit, MI 48236-2148
Mailing address
3319 Greenfield Rd
PMB #428
Dearborn, MI 48120-1212
Phone (519) 890-2398
Other providers in Detroit, MI
- Navin Abro
- Bowen Angela Absher
- Absolute Timely Home Care Inc
- Absolute Transportation Company
- Steven Abu Al Tamn
- Raya Abu Tawileh
- Daoud K Abu-Hamdan
- Maha Nazmi Abu-Khdeir
- Mohammed Z. Abu-Mahfouz
- Kamal Abu-Rashed
All providers in Detroit, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.