Dave, Amita N
Dave, Amita N is an sole proprietor health care provider with primary practice located at 3825 Medical Park Dr Suite 201, Austell GA 30106-6831. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Dave, Amita N can be contacted via phone (770) 941-8100.Contact Information
Primary practice address
3825 Medical Park Dr Suite 201
Austell GA 30106-6831
Phone: (770) 941-8100
Fax: (678) 945-9331
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 023724 | Georgia |
Profile Details
| NPI number | 1609859735 |
|---|---|
| LBN Legal business name | Dave, Amita N |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 22nd, 2005 |
| Last updated | Nov 13th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609859735 | NPPES |
| Georgia | Other | 062147 | BLUE CROSS |
| Georgia | Other | 003116112A | BLUE CROSS |
| Georgia | MEDICAID | 000405402D | BLUE CROSS |
| Georgia | Other | 110124115 | BLUE CROSS |
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