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NPI Code Detail

MEDICARE: AMIN HANOI JIMINIAN WILMOT M.D.

MEDICARE: AMIN HANOI JIMINIAN WILMOT 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
1207R00000XInternal Medicine Physician01078506IN
2208M00000XHospitalist PhysicianME113450FL
3208M00000XHospitalist Physician73475WI
4208M00000XHospitalist Physician01078506AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710268412
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMIN HANOI JIMINIAN WILMOT M.D.
Provider Business Mailing Address
First Line : 2401 W UNIVERSITY AVE
Second Line : RCS PROVIDER ENROLLMENT
City : MUNCIE
State : IN
Zip : 47303-3428
Country : US
Telephone Number : 765-741-1515
Fax Number : 765-751-5087
Provider Business Practice Location Address
First Line : 2776 CLEVELAND AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-5855
Country : US
Telephone Number : 239-424-1449
Fax Number : 239-424-1421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2011
Last Update Date : 06/29/2021

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