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General NPI Number Information
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NPI Number | 1033679493
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Entity Type | Individual
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Provider Name | SHIVAM VIPUL AMIN MD
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Gender | Male
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 2055 NORMANDIE DR STE 314
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City | MONTGOMERY
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State | AL
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Zip | 36111-2732
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Country | US
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Telephone | 334-263-0105
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Fax | 334-264-4386
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Provider Business Mailing Address
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Address Line | 2101 HIGHLAND AVE S STE 350
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City | BIRMINGHAM
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State | AL
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Zip | 35205-4009
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Country | US
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Telephone | 334-263-0105
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Fax | 334-264-4386
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 125073564
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 81518
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD.50972
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License Number State | AL
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