MEDICARE: RAJENDRA AMIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	11099	TX
2	207L00000X	Anesthesiology Physician	11099	OK

General Provider Information

NPI Number	:	1104821792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAJENDRA AMIN MD

Provider Business Mailing Address
First Line	:	1044 S.W. 44TH ST.
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73109
Country	:	US
Telephone Number	:	405-631-4263
Fax Number	:	405-616-2670

Provider Business Practice Location Address
First Line	:	1044 S.W. 44TH ST.
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73109
Country	:	US
Telephone Number	:	405-631-4263
Fax Number	:	405-631-4820

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	01/06/2022

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