Provider Demographics
NPI:1710987060
Name:AMIN, JATIN D (MD)
Entity Type:Individual
Prefix:
First Name:JATIN
Middle Name:D
Last Name:AMIN
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 1:730 N MACOMB ST
Mailing Address - Street 2:STE 429
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-2900
Mailing Address - Country:US
Mailing Address - Phone:734-242-7060
Mailing Address - Fax:734-241-7580
Practice Address - Street 1:730 N MACOMB ST
Practice Address - Street 2:STE 429
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-2900
Practice Address - Country:US
Practice Address - Phone:734-242-7060
Practice Address - Fax:734-241-7580
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35067725A207RC0000X
MIJA064701207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH02187OtherPARAMOUNT
OH5517925793006OtherMEDICAL MUTUAL OHIO
MI0981811OtherHEALTH PLAN OF MICHIGAN
MIF12361OtherHEALTH ALLIANCE PLAN
OH0131084Medicaid
MI700E860190OtherBCBSMI
OH000000186467OtherANTHEM BCBS
OH060037692OtherMEDICARE RAILROAD
OH25014177OtherUNITED HEALTHCARE
OH00046700OtherAETNA
MI25014177OtherUNITED HEALTHCARE
MI3127890Medicaid
MI060037692OtherMEDICARE RAILROAD
OH0131084Medicaid
MI3127890Medicaid
OH0775072Medicare PIN
MIE860190003Medicare ID - Type Unspecified
OH5517925793006OtherMEDICAL MUTUAL OHIO
MI060037692OtherMEDICARE RAILROAD
OHF12361Medicare UPIN