Provider Demographics
NPI:1104289743
Name:AMIN, SHAMEL (MD)
Entity type:Individual
Prefix:
First Name:SHAMEL
Middle Name:
Last Name:AMIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3901 BEAUBIEN ST
Mailing Address - Street 2:CARL'S BUILDING, 5TH FLOOR, GI DIVISION
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2196
Mailing Address - Country:US
Mailing Address - Phone:313-745-5585
Mailing Address - Fax:313-745-5155
Practice Address - Street 1:3901 BEAUBIEN ST
Practice Address - Street 2:GI DIVISION
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2119
Practice Address - Country:US
Practice Address - Phone:313-745-7496
Practice Address - Fax:313-993-7118
Is Sole Proprietor?:No
Enumeration Date:2016-03-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301119326208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics