Provider Demographics
NPI:1144038365
Name:AMEN FAMILY MEDICINE PLLC
Entity type:Organization
Organization Name:AMEN FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HUSSEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-598-8033
Mailing Address - Street 1:27221 TIMBER TRL
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-3363
Mailing Address - Country:US
Mailing Address - Phone:313-598-8033
Mailing Address - Fax:
Practice Address - Street 1:36016 FIVE MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1918
Practice Address - Country:US
Practice Address - Phone:313-598-8033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty