Provider Demographics
NPI:1972565315
Name:AMIN, BIRAL S (MD)
Entity Type:Individual
Prefix:DR
First Name:BIRAL
Middle Name:S
Last Name:AMIN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12100 WARWICK BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-2365
Practice Address - Country:US
Practice Address - Phone:757-594-2644
Practice Address - Fax:757-594-3134
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2014-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01012386692085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAI41438Medicare UPIN
VAI41438Medicare UPIN