Provider Demographics
NPI:1861651341
Name:BEATTIE, AMANDA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:LYNN
Last Name:BEATTIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1803 MOUNT ROSE AVE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-1999
Practice Address - Street 1:25 MONUMENT RD
Practice Address - Street 2:STE 120
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5060
Practice Address - Country:US
Practice Address - Phone:717-851-6110
Practice Address - Fax:717-851-1999
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2011-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD442620208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102615939Medicaid
PA416890OtherUPMC
PA30100323OtherAMERIHEALTH MERCY-WMG
MD044033700Medicaid
PA1599421OtherGATEWAY
PA2637676OtherHIGHMARK BLUE SHIELD
PA1599421OtherGATEWAY