Individual
AMANDA ISMAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7001 ORCHARD LAKE RD STE 200, WEST BLOOMFIELD, MI 48322-3606
(248) 538-7400
Mailing address
6689 ORCHARD LAKE RD # 297, WEST BLOOMFIELD, MI 48322-3404
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
4301502871
MI
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
Primary
4301502871
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2016
Last updated
03/10/2021
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