Individual
DR. AMANDA LYNN MINICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
6450 MAPLE ST, DEARBORN, MI 48126-2259
(313) 842-7010
(313) 842-5150
Mailing address
4939 CROOKS RD, ROYAL OAK, MI 48073-1202
(517) 449-2105
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101018160
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5101018160
—
MI
Enumeration date
07/13/2009
Last updated
10/12/2018
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