Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 0101236604 | VA |
Y | 111NI0900X | Internist | 0101236604 | VA |
N | 207RH0002X | Hospice and Palliative Medicine | 0101236604 | VA |
N | 207RS0012X | Sleep Medicine | 0101236604 | VA |
NPI | 1255315081 |
---|---|
Provider Name | Abdul Latif Amir |
First Address | Colonial Heights, VA 23834-3610 |
Second Address | Richmond, VA 23229-5205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2005 |
Last Update Date | 24/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10130930 | (05) | VA |
1255315081 | (05) | VA |
139451 | ANTHEM (01) | VA |
302011 | ANTHEM BCBS (01) | VA |
I07416 | (02) | |
P00136200 | MEDICARE RR (01) | VA |
P00601104 | MEDICARE RAILROAD (01) | VA |