Provider Demographics
NPI:1023363736
Name:PEDRICK, AMANDA M (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:M
Last Name:PEDRICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5400 FRANTZ RD
Mailing Address - Street 2:STE 250
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4144
Mailing Address - Country:US
Mailing Address - Phone:614-544-6210
Mailing Address - Fax:614-544-6370
Practice Address - Street 1:3535 OLENTANGY RIVER RD
Practice Address - Street 2:STE 220
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3908
Practice Address - Country:US
Practice Address - Phone:614-566-4924
Practice Address - Fax:614-566-6636
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2016-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35.1286102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry