Individual
MOHAMMAD NURUL AMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2157 ORCHARD LAKE DRIVE, SYLVAN LAKE, MI 48320
(248) 857-7878
(248) 857-7888
Mailing address
2157 ORCHARD LAKE DRIVE, SYLVAN LAKE, MI 48320
(248) 857-7878
(248) 857-7888
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301048260
MI
208000000X
Pediatrics Physician
MA048260
MI
208D00000X
General Practice Physician
4301048260
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083612840
—
MI
05
—
1759477
—
MI
01
—
3506305691
BCBS IND
MI
Enumeration date
07/14/2005
Last updated
05/03/2021
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