Provider Demographics
NPI:1568626828
Name:DYE, AMANDA STEPHENS (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:STEPHENS
Last Name:DYE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:63 CORPORATE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SCOTT DEPOT
Mailing Address - State:WV
Mailing Address - Zip Code:25560-7841
Mailing Address - Country:US
Mailing Address - Phone:304-691-8901
Mailing Address - Fax:304-691-1969
Practice Address - Street 1:300 CORPORATE CENTER DR.
Practice Address - Street 2:
Practice Address - City:SCOTT DEPOT
Practice Address - State:WV
Practice Address - Zip Code:25560
Practice Address - Country:US
Practice Address - Phone:304-691-6800
Practice Address - Fax:304-691-6751
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2021-12-27
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Provider Licenses
StateLicense IDTaxonomies
WV244212080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810021067Medicaid
WVWV0488AMedicare PIN