AMANDA DAKROUB MD PLLC NPI 1790193084

NPI Information

NPI: 1790193084
Provider Name: AMANDA DAKROUB MD PLLC

Former Legal Business Name: AMANDA KAUFMAN MD PLLC

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
2880 S. STATE STREET
SUITE 215
ANN ARBOR, MI
ZIP 48104
Phone: (734) 547-3990
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AMANDA DAKROUB MD PLLC is a primary care clinic center in Ann Arbor, MI. AMANDA DAKROUB MD PLLC NPI is 1790193084. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Amanda Kaufman Md Pllc.

The provider's business location address is:

2880 S. STATE STREET
SUITE 215
ANN ARBOR, MI
ZIP 48104
Phone: (734) 547-3990
Fax: (734) 547-3980

The provider's authorized official is Amanda Joy Dakroub .
The authorized official title is PHYSICIAN OWNEROwner and has the following contact phone number (734) 547-3990.

The enumeration date for this NPI number is 7/30/2014 and was last updated on 8/11/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	4301081734	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	4778340	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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