Provider Demographics
NPI:1396955134
Name:HIMMED, AMANUEL SAMAD (MD)
Entity type:Individual
Prefix:DR
First Name:AMANUEL
Middle Name:SAMAD
Last Name:HIMMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 PARK AVE W
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-3706
Mailing Address - Country:US
Mailing Address - Phone:855-446-7348
Mailing Address - Fax:
Practice Address - Street 1:680 PARK AVE W
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-3706
Practice Address - Country:US
Practice Address - Phone:855-446-7348
Practice Address - Fax:813-672-6197
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME153168207RA0401X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine