Individual
DR. AMANDA PROVOST CIMINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
17000 HUBBARD DR, DEARBORN, MI 48126-4258
(313) 982-4351
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1922
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5315216509
MI
Other
Enumeration date
05/15/2020
Last updated
06/27/2023
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