Provider Demographics
NPI:1295113132
Name:AJAMI, SAMIH MIKE (DO)
Entity type:Individual
Prefix:
First Name:SAMIH
Middle Name:MIKE
Last Name:AJAMI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 446
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48106-0446
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:
Practice Address - Street 1:6300 N HAGGERTY RD
Practice Address - Street 2:STE 220
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-4472
Practice Address - Country:US
Practice Address - Phone:313-283-1019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101021653207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine