Provider Demographics
NPI:1619780780
Name:AMIN, MIRZA SAJID (PA)
Entity type:Individual
Prefix:
First Name:MIRZA
Middle Name:SAJID
Last Name:AMIN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:477 HUTCHINSON ST
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-4349
Mailing Address - Country:US
Mailing Address - Phone:614-779-6697
Mailing Address - Fax:
Practice Address - Street 1:477 HUTCHINSON ST
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-4349
Practice Address - Country:US
Practice Address - Phone:614-779-6697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical