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Mr. Theourn Amalathasan, MD
Student in an Organized Health Care Education/Training Program in Southfield, Michigan
NPI 1689366767

Theourn Amalathasan is a Student in an Organized Health Care Education/Training Program based in Southfield, MI. Theourn Amalathasan practices in Southfield, MI and has the professional credentials of MD. The NPI Number for Theourn Amalathasan is 1689366767 and holds a License No. (Michigan).

The current practice location address for Theourn Amalathasan is 22250 Providence Drive, Southfield, MI and can be reached out via phone at 248-849-3254 and via fax at 248-849-5449.

Location: 22250 Providence Drive, Southfield, MI, 48075-4818
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1689366767
Provider Name
Theourn Amalathasan
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
22250 Providence Drive, Southfield, MI, 48075-4818
Phone Number
248-849-3254
Fax Number
248-849-5449
Provider Enumeration Date
05/25/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
22250 Providence Drive
City
Southfield
State
Michigan
Zip
48075-4818
Phone Number
248-849-3254
Fax Number
248-849-5449
person
Provider Business Mailing Address Details
Address
22250 Providence Drive
City
Southfield
State
Michigan
Zip
48075-4818
Phone Number
248-849-3254
Fax Number
248-849-5449
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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