Provider Demographics
NPI:1881484632
Name:AMERICAN ID GROUP LLC
Entity type:Organization
Organization Name:AMERICAN ID GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROHIT
Authorized Official - Middle Name:
Authorized Official - Last Name:KALIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-440-1086
Mailing Address - Street 1:1116 RED PORCH LN
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-4972
Mailing Address - Country:US
Mailing Address - Phone:786-440-1086
Mailing Address - Fax:
Practice Address - Street 1:2333 MCCALLIE AVE STE 401
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3258
Practice Address - Country:US
Practice Address - Phone:786-440-1086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty