MEDICARE: VAIBHAV AMIN M.D.

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	207RC0000X	Cardiovascular Disease Physician	079807	GA

General Provider Information

NPI Number	:	1679830988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VAIBHAV AMIN M.D.

Provider Business Mailing Address
First Line	:	144 BILL CARRUTH PKWY STE 4200
Second Line	:
City	:	HIRAM
State	:	GA
Zip	:	30141-3819
Country	:	US
Telephone Number	:	678-324-4444
Fax Number	:	770-528-9932

Provider Business Practice Location Address
First Line	:	144 BILL CARRUTH PKWY STE 4200
Second Line	:
City	:	HIRAM
State	:	GA
Zip	:	30141-3819
Country	:	US
Telephone Number	:	678-324-4444
Fax Number	:	770-528-9932

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

Provider Enumeration Date	:	04/12/2012
Last Update Date	:	07/12/2023

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