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Individual

JITENDRA M AMIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
725 N SPENCER ST, RUSHVILLE, IN 46173
(765) 932-5996
(765) 932-4996
Mailing address
PO BOX 245, 725 N SPENCER ST, RUSHVILLE, IN 46173
(765) 932-5996
(765) 932-4996

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01030547A
IN
207R00000X
Internal Medicine Physician
Primary
01030547A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100216000A
IN
Enumeration date
11/02/2005
Last updated
07/13/2010
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