Individual
AMANDA JIDDOU ROOSEVELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5301 EAST HURON RIVER, ANESTHESIA DEPARTMENT, YPSILANTI, MI 48197
(734) 712-3456
Mailing address
2006 HOGBACK RD STE 5A, ANN ARBOR, MI 48105-9750
(734) 263-2400
(734) 773-3471
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301103232
MI
Other
Enumeration date
05/13/2013
Last updated
10/11/2024
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