Provider Demographics
NPI:1982645198
Name:AMIN, HOMAYOUN S (MD)
Entity Type:Individual
Prefix:
First Name:HOMAYOUN
Middle Name:S
Last Name:AMIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3333 JODECO RD
Mailing Address - Street 2:STE. A
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253
Mailing Address - Country:US
Mailing Address - Phone:770-692-4000
Mailing Address - Fax:770-474-8510
Practice Address - Street 1:3333 JODECO RD
Practice Address - Street 2:STE. A
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253
Practice Address - Country:US
Practice Address - Phone:770-692-4000
Practice Address - Fax:770-474-8510
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2024-02-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA030427207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00359664CMedicaid
D44711Medicare UPIN
06BDCQJMedicare ID - Type Unspecified