MEDICARE: MEGHA AMIN

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	363LF0000X	Family Nurse Practitioner	RN214300	GA

General Provider Information

NPI Number	:	1710346325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHA AMIN

Provider Business Mailing Address
First Line	:	5060 LAKEBROOKE RUN
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30087-3403
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4535 WINTERS CHAPEL RD
Second Line	:
City	:	DORAVILLE
State	:	GA
Zip	:	30360-2705
Country	:	US
Telephone Number	:	770-285-7246
Fax Number	:	770-999-0809

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

Provider Enumeration Date	:	02/11/2016
Last Update Date	:	02/07/2020

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Directions to “ MEGHA AMIN ” Practice Location

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