Individual
DR. AMY INDENBAUM GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
28455 HAGGERTY RD, STE 200, NOVI, MI 48377
(248) 893-3200
(248) 893-2950
Mailing address
6676 SOLUTIONS CTR, CHICAGO, IL 60677-6006
(248) 893-3220
(248) 893-2951
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301054480
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4258645
—
MI
Enumeration date
10/10/2005
Last updated
05/14/2018
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