Provider Demographics
NPI:1760649800
Name:BOONE, AMANDA CHERIE (MD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:CHERIE
Last Name:BOONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:SCHAEFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:975 E. THIRD STREET
Mailing Address - Street 2:ATTN: PROVIDER ENROLLMENT
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2147
Mailing Address - Country:US
Mailing Address - Phone:844-439-1729
Mailing Address - Fax:423-778-2108
Practice Address - Street 1:975 E. THIRD STREET
Practice Address - Street 2:ATTN: PROVIDER ENROLLMENT
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2147
Practice Address - Country:US
Practice Address - Phone:844-439-1729
Practice Address - Fax:423-778-2108
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015025548207Q00000X
WI54490-20207Q00000X
WYTL3131207Q00000X
TN53360207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine