Provider Demographics
NPI:1003900762
Name:ATUL K. AMIN, MD PC
Entity type:Organization
Organization Name:ATUL K. AMIN, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ATUL
Authorized Official - Middle Name:K
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-258-3375
Mailing Address - Street 1:3729 NAZARETH RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8344
Mailing Address - Country:US
Mailing Address - Phone:610-258-3375
Mailing Address - Fax:610-258-3946
Practice Address - Street 1:3729 NAZARETH ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045
Practice Address - Country:US
Practice Address - Phone:610-258-3375
Practice Address - Fax:610-258-3946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022051E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000807Medicare ID - Type Unspecified