Provider Demographics
NPI:1073776274
Name:ROBERTS, AMANDA YOUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:YOUNG
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:I
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:525 N CLEVELAND MASSILLON RD
Mailing Address - Street 2:STE. 203
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3360
Mailing Address - Country:US
Mailing Address - Phone:330-666-9769
Mailing Address - Fax:330-666-7530
Practice Address - Street 1:525 N CLEVELAND MASSILLON RD
Practice Address - Street 2:STE. 203
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-3360
Practice Address - Country:US
Practice Address - Phone:330-666-9769
Practice Address - Fax:330-666-7530
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.095233207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine