Individual
AL MUTHANNA AMJAD SHADID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2799 W. GRAND BOULEVARD, DETROIT, MI 48202-2608
(313) 916-1888
Mailing address
2799 W. GRAND BOULEVARD, DETROIT, MI 48202-2608
(313) 916-1888
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
4351048263
MI
Other
Enumeration date
07/12/2021
Last updated
07/12/2021
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