Provider Demographics
NPI:1013279017
Name:SAUNDERS, AMANDA VAUGHN (DO)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:VAUGHN
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:AUDREY
Other - Last Name:VAUGHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10540 BEDFORDTOWN DR
Mailing Address - Street 2:PRIVATE ADDRESS
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-8069
Mailing Address - Country:US
Mailing Address - Phone:919-780-8423
Mailing Address - Fax:
Practice Address - Street 1:55 TW ALEXANDER DR
Practice Address - Street 2:OFFICE
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27709-0152
Practice Address - Country:US
Practice Address - Phone:919-425-5479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC184104208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice