Healthcare Provider Details

I. General information

NPI: 1225024995
Provider Name (Legal Business Name): RUPAL V. AMIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RUPAL V. DINESH M.D.

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 11/10/2020
Certification Date: 11/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 DUFF AVE
AMES IA
50010-5400
US

IV. Provider business mailing address

1215 DUFF AVE
AMES IA
50010-5400
US

V. Phone/Fax

Practice location:
  • Phone: 515-239-4431
  • Fax: 515-239-4742
Mailing address:
  • Phone: 515-239-4431
  • Fax: 515-239-4742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number31804
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: