Provider Demographics
NPI:1306120498
Name:AMIT, AMIT (MD)
Entity type:Individual
Prefix:DR
First Name:AMIT
Middle Name:
Last Name:AMIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 KIRTS BLVD
Mailing Address - Street 2:APT 228
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4804
Mailing Address - Country:US
Mailing Address - Phone:248-250-3830
Mailing Address - Fax:
Practice Address - Street 1:1303 KIRTS BLVD
Practice Address - Street 2:APT 228
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4804
Practice Address - Country:US
Practice Address - Phone:248-250-3830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL2074613207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI000201877OtherDMC