Provider Demographics
NPI:1225246242
Name:GODFREY, AMANDA MARIE KOROLY (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MARIE KOROLY
Last Name:GODFREY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR
Mailing Address - Street 2:PO BOX 0446 LOBBY J
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:5333 MCAULEY DR
Practice Address - Street 2:STE 3111
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1014
Practice Address - Country:US
Practice Address - Phone:734-712-7688
Practice Address - Fax:734-712-7056
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2013-07-09
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Provider Licenses
StateLicense IDTaxonomies
MI4301087967207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease