Provider Demographics
NPI:1003896994
Name:AMAN, TAMRA (DO)
Entity type:Individual
Prefix:DR
First Name:TAMRA
Middle Name:
Last Name:AMAN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 SPRING VALLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25704
Mailing Address - Country:US
Mailing Address - Phone:304-429-6741
Mailing Address - Fax:304-429-0262
Practice Address - Street 1:1540 SPRING VALLEY DRIVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25704
Practice Address - Country:US
Practice Address - Phone:304-429-6741
Practice Address - Fax:304-429-0262
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2023207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810003271Medicaid
WVPO1065168OtherRR MEDICARE
WV1003896994OtherHIGHMARK WV
WV00251341OtherRR MEDICARE
WV00251341OtherRR MEDICARE
WVPO1065168OtherRR MEDICARE
WV3810003271Medicaid