| Doctor Name: | MOHAMMAD NURUL AMIN |
| NPI Number: | 1083612840 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 4301048260 |
| Business Practice Address: | 2157 Orchard Lake Drive Sylvan Lake, MI - 48320 |
| Business Phone Number: | 2488577878 |
| Business Fax Number: | 2488577888 |
| Mailing Address: | 2157 Orchard Lake Drive, SYLVAN LAKE |
| State: | MI |
| Postal Code: | 48320 |
| Phone Number: | 2488577878 |
| Fax Number: | 2488577888 |
| NPI Enumeration Date: | 07/14/2005 |
| NPI Last Update Date: | 02/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 4301048260 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |