Provider Demographics
NPI:1063577625
Name:AMINOVA, SVETLANA O (MD)
Entity type:Individual
Prefix:
First Name:SVETLANA
Middle Name:O
Last Name:AMINOVA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 71011
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-0019
Mailing Address - Country:US
Mailing Address - Phone:248-879-2836
Mailing Address - Fax:248-551-1110
Practice Address - Street 1:1701 SOUTH BLVD E
Practice Address - Street 2:SUITE 160
Practice Address - City:ROCHESTER HLS
Practice Address - State:MI
Practice Address - Zip Code:48307-6122
Practice Address - Country:US
Practice Address - Phone:248-598-5080
Practice Address - Fax:248-598-5080
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2008-02-26
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Provider Licenses
StateLicense IDTaxonomies
MI4301080284207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP27310002Medicare PIN