Provider Demographics
NPI:1477992360
Name:WINSTON, AMANDA L (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:L
Last Name:WINSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9244 LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-1757
Mailing Address - Country:US
Mailing Address - Phone:810-653-2111
Mailing Address - Fax:810-653-8506
Practice Address - Street 1:9040 DAVISON RD
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-1037
Practice Address - Country:US
Practice Address - Phone:810-412-5700
Practice Address - Fax:810-412-5755
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-24
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301103706208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics