Provider Demographics
NPI:1649536145
Name:AMIN, NIKITA TUSHAR (MD)
Entity type:Individual
Prefix:
First Name:NIKITA
Middle Name:TUSHAR
Last Name:AMIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NIKITA
Other - Middle Name:TUSHAR
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1800 HOWELL MILL RD NW STE 800
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-0922
Mailing Address - Country:US
Mailing Address - Phone:678-298-3239
Mailing Address - Fax:404-477-1162
Practice Address - Street 1:1800 HOWELL MILL RD NW STE 800
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-0922
Practice Address - Country:US
Practice Address - Phone:404-350-9853
Practice Address - Fax:404-350-8407
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA77173207RH0003X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program