AMANDA M BASIL-PORTER

SAINT CLAIR SHORES, MI
NPI1528441854
Former NameAMANDA M AJINE-BASIL
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MI  5601009765)
Additional Taxonomies363A00000X Physician Assistant
(Licence: PA  MA057154)
Enumeration Date2015-07-06
Last Update Date2021-01-19
Business Address
AMANDA M BASIL-PORTER PA-C
25631 LITTLE MACK AVE STE 205
SAINT CLAIR SHORES, MI 48081-2108
Phone number: 586-443-2380
Mailing Address
AMANDA M BASIL-PORTER PA-C
26901 BEAUMONT BLVD
SOUTHFIELD, MI 48033-3849
Phone number: 248-577-3313