Provider Demographics
NPI:1114679362
Name:AMANDA DORN, MD, PLLC
Entity Type:Organization
Organization Name:AMANDA DORN, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:STINE
Authorized Official - Last Name:DORN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-928-0144
Mailing Address - Street 1:101 EUROPA DR STE 170
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-2378
Mailing Address - Country:US
Mailing Address - Phone:919-928-0144
Mailing Address - Fax:919-928-0145
Practice Address - Street 1:101 EUROPA DR STE 170
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-2378
Practice Address - Country:US
Practice Address - Phone:919-928-0144
Practice Address - Fax:919-928-0145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty