Provider Demographics
NPI:1386716280
Name:JAMIL, MADA H (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:MADA
Middle Name:H
Last Name:JAMIL
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:MADA
Other - Middle Name:
Other - Last Name:KARMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6055 19 MILE RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-2105
Mailing Address - Country:US
Mailing Address - Phone:248-557-4443
Mailing Address - Fax:248-557-0573
Practice Address - Street 1:6055 19 MILE RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-2105
Practice Address - Country:US
Practice Address - Phone:248-557-4443
Practice Address - Fax:248-557-0573
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010729542083X0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700E012740OtherBCBSM GROUP PIN
MIH68569Medicare UPIN
MI700E012740OtherBCBSM GROUP PIN