Provider Demographics
NPI:1396292322
Name:AMERICAN MEDICAL CENTER GROUP PLLC
Entity type:Organization
Organization Name:AMERICAN MEDICAL CENTER GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUNIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-557-3303
Mailing Address - Street 1:20905 GREENFIELD RD STE 603M
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5355
Mailing Address - Country:US
Mailing Address - Phone:248-557-3303
Mailing Address - Fax:586-722-2722
Practice Address - Street 1:20905 GREENFIELD RD STE 603M
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5355
Practice Address - Country:US
Practice Address - Phone:248-557-3303
Practice Address - Fax:586-722-2722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301068351207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301068351Medicaid