Shivan H Amin, MD | |
2675 N Decatur Rd, Ste 707, Decatur, GA 30033-6131 | |
(404) 501-7710 | |
(404) 501-7215 |
Full Name | Shivan H Amin |
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Gender | Male |
Speciality | Otolaryngology - Otolaryngology/facial Plastic Surgery |
Location | 2675 N Decatur Rd, Decatur, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1275857542 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Y00000X | Otolaryngology | A108630 (California) | Secondary |
207YX0905X | Otolaryngology - Otolaryngology/facial Plastic Surgery | 67525 (Georgia) | Primary |
Entity Name | Gwinnett Physician Group, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1578574661 PECOS PAC ID: 9133211139 Enrollment ID: O20070822001035 |
Entity Name | Northside Primary Care Professional Services,llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922397553 PECOS PAC ID: 9638343924 Enrollment ID: O20111123000206 |
Entity Name | Origin Healthcare Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1689266314 PECOS PAC ID: 8527477249 Enrollment ID: O20210511000590 |
Mailing Address | Practice Location Address |
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Shivan H Amin, MD 1060 Virginia Ave Ne, Atlanta, GA 30306-3526 Ph: (267) 456-4313 | Shivan H Amin, MD 2675 N Decatur Rd, Ste 707, Decatur, GA 30033-6131 Ph: (404) 501-7710 |
Dr. Jenny Christine Kim, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 484 Irvin Ct, Ste 140, Decatur, GA 30030 Phone: 404-297-4230 Fax: 404-297-4252 | |
Dr. Melissa Soo-yung Oh, MD Otolaryngology Medicare: Medicare Enrolled Practice Location: 484 Irvin Ct Ste 140, Decatur, GA 30030 Phone: 404-297-4230 Fax: 404-297-4252 | |
Preston Leigh Imhof, D.O. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 2675 N Decatur Rd, Suite 707, Decatur, GA 30033 Phone: 404-501-7710 | |
Dr. Michelle Marie Cullen, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 1670 Clairmont Rd, Decatur, GA 30033 Phone: 404-321-6111 | |
Dr. Thomas Strother Edwards, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 2675 N Decatur Rd Ste 707, Decatur, GA 30033 Phone: 404-501-7710 |