Provider Demographics
NPI:1639914328
Name:MAHAL, AMANPREET S (MD)
Entity type:Individual
Prefix:
First Name:AMANPREET
Middle Name:S
Last Name:MAHAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:AMANPREET
Other - Middle Name:S
Other - Last Name:MAHAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:21049 HUNTERS RDG
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-9617
Mailing Address - Country:US
Mailing Address - Phone:248-832-1995
Mailing Address - Fax:
Practice Address - Street 1:718 N MACOMB ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-7815
Practice Address - Country:US
Practice Address - Phone:734-240-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351053486207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine