Individual
ANISHA ASHWIN AMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1141 S INDIANA AVE, CROWN POINT, IN 46307-7205
(219) 662-0700
(219) 662-0973
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01054193A
IN
208000000X
Pediatrics Physician
35077875
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000391410
BCBS
—
01
—
000000721901
ANTHEM TRADITIONAL
IN
05
—
200333720
—
IN
05
—
2647149
—
OH
Enumeration date
05/16/2006
Last updated
02/15/2023
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