Diane Dritt Amin, PA-C

Individual provider Active NPI Physician Assistant · Phoenix, MD

NPI 1063561298 · NPPES record last updated Oct 20, 2011

Key facts

NPI
1063561298
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
C0001033 (MD)
Practice address
2427 Stanwick Rd
Phoenix, MD 21131-1544
Phone
(410) 683-1719
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0001033MDMDPhysician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0001033 MD Yes

Addresses

Primary practice location

2427 Stanwick Rd
Phoenix, MD 21131-1544

Mailing address

2427 Stanwick Rd
Phoenix, MD 21131-1544
Phone (410) 683-1719

Other providers in Phoenix, MD

All providers in Phoenix, MD · Physician Assistant in Maryland

Sources for this page

Verify at the official NPI Registry.