Individual
AMIT OM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1918 RANDOLPH RD STE 550, CHARLOTTE, NC 28207-1114
(704) 375-6766
(864) 560-7343
Mailing address
1301 20TH ST STE 570, SANTA MONICA, CA 90404-2118
(310) 315-0171
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
168537
CA
207N00000X
Dermatology Physician
Primary
2022-00012
NC
Other
Enumeration date
06/21/2016
Last updated
08/03/2022
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