Doctor Name: | DR. MOHAMMAD BASIL AMIN |
NPI Number: | 1104881101 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D |
License Number: | ME0072588 |
Business Practice Address: | 205 Zeagler Dr. Suite # 401-b Palatka, FL - 32177 |
Business Phone Number: | 3863258482 |
Business Fax Number: | 3863253512 |
Mailing Address: | Po Box 2468, PALATKA |
State: | FL |
Postal Code: | 32177 |
Phone Number: | 3863258482 |
Fax Number: | 3863253512 |
NPI Enumeration Date: | 04/20/2006 |
NPI Last Update Date: | 04/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207RA0401X |
License Number: | ME0072588 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Internal Medicine |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |