Provider Demographics
NPI:1982706784
Name:AMIN, ATUL K (MD)
Entity type:Individual
Prefix:DR
First Name:ATUL
Middle Name:K
Last Name:AMIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3735 EASTON NAZARETH HWY
Mailing Address - Street 2:SUITE 302
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8338
Mailing Address - Country:US
Mailing Address - Phone:610-258-3375
Mailing Address - Fax:610-258-3946
Practice Address - Street 1:3735 EASTON NAZARETH HWY
Practice Address - Street 2:SUITE 302
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8338
Practice Address - Country:US
Practice Address - Phone:610-258-3375
Practice Address - Fax:610-258-3946
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022051E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC30595Medicare UPIN
PA117313DXFMedicare ID - Type Unspecified