Provider Demographics
NPI:1003852807
Name:AMSTERDAM, JAMES T (DMD, MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:T
Last Name:AMSTERDAM
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 WYNDHAM DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-5914
Mailing Address - Country:US
Mailing Address - Phone:717-854-1255
Mailing Address - Fax:
Practice Address - Street 1:1735 WYNDHAM DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5914
Practice Address - Country:US
Practice Address - Phone:717-854-1255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025912E207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1852175OtherHIGHMARK BLUE SHIELD-YH
PA20038408OtherAMERIHEALTH MERCY-YH
PA000894520Medicaid
PA100995OtherGEISINGER-YH
PA173652OtherUNISON-YH
PA2709050000OtherAMERIHEALTH 65 PA-YH
PA50067202OtherCAPITAL BLUE CROSS-YH
PA1544581OtherGATEWAY-YH
PA20038408OtherAMERIHEALTH MERCY-YH
E29265Medicare UPIN
PA000894520Medicaid