Provider Demographics
NPI:1497019210
Name:JAMINDAR, PARTH (MD)
Entity Type:Individual
Prefix:
First Name:PARTH
Middle Name:
Last Name:JAMINDAR
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 1:1499 WALTON WAY
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2602
Mailing Address - Country:US
Mailing Address - Phone:706-721-2423
Mailing Address - Fax:
Practice Address - Street 1:2435 W BELVEDERE AVE STE 56
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5224
Practice Address - Country:US
Practice Address - Phone:410-601-5200
Practice Address - Fax:410-601-7749
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005664207R00000X
GA074275207R00000X
MDD91111207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGA1772OtherSC MEDICAID
GA295071OtherMEDCOST
GA10000164877OtherBCBS GA
GA003162444AMedicaid
GAGA1772OtherSC MEDICAID