Avazeh Amirsadri
Nurse Practitioner, Family in Detroit, MI. Individual provider (NPI-1).
NPI number1780174631
StatusActive
Last updated in NPPESMay 16, 2018
Details
- NPI
- 1780174631
- Entity type
- Individual (NPI-1)
- Name
- Avazeh Amirsadri
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 16, 2018
- Last updated
- May 16, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Part B No · DME Yes · Home health No · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 4704297524 | MI | Yes |
Practice location
6071 W Outer DrDetroit, MI 48235-2624
Phone 313-993-2966
Mailing address
38365 WindsorFarmington Hills, MI 48331-2851
Phone 248-910-2958
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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