Provider Demographics
NPI:1093830176
Name:AMIN, CHIRAG JITENDRA (MD)
Entity type:Individual
Prefix:DR
First Name:CHIRAG
Middle Name:JITENDRA
Last Name:AMIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 440100
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0100
Mailing Address - Country:US
Mailing Address - Phone:615-871-9996
Mailing Address - Fax:615-871-9661
Practice Address - Street 1:5653 FRIST BLVD
Practice Address - Street 2:SUITE 434
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2062
Practice Address - Country:US
Practice Address - Phone:615-871-9996
Practice Address - Fax:615-871-9661
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN52195207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200907690Medicaid
P00693291OtherRAILROAD MEDICARE
IN200907690Medicaid
NC55864UMedicare UPIN