Provider Demographics
NPI:1629185202
Name:GROWDON, AMANDA S (MD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:S
Last Name:GROWDON
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1 CHARLES ST S
Mailing Address - Street 2:UNIT 2D
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-5447
Mailing Address - Country:US
Mailing Address - Phone:617-355-4993
Mailing Address - Fax:617-730-0884
Practice Address - Street 1:300 LONGWOOD AVE, MAIN S 9156
Practice Address - Street 2:CHILDREN'S HOSPITAL BOSTON
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-355-4993
Practice Address - Fax:617-730-0884
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2009-05-26
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Provider Licenses
StateLicense IDTaxonomies
MA227056208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics