Individual
AMIT V. TIBREWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1505 NORTHSIDE FORSYTH DR, STE 3600, CUMMING, GA 30041
(770) 343-8565
(770) 781-3559
Mailing address
873 BRIGHTWATER CIR, MAITLAND, FL 32751-4233
(407) 284-1914
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
068325
GA
207RC0000X
Cardiovascular Disease Physician
ME 108835
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003125698D
—
GA
05
—
003125698L
—
GA
05
—
003125698M
—
GA
05
—
003125698N
—
GA
Enumeration date
09/28/2007
Last updated
12/15/2020
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