Provider Demographics
NPI:1023326519
Name:TAITINGFONG, AMBER KATHRYN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:KATHRYN
Last Name:TAITINGFONG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3581 DAVIS DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-8807
Mailing Address - Country:US
Mailing Address - Phone:919-460-8577
Mailing Address - Fax:919-460-4418
Practice Address - Street 1:3581 DAVIS DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-8807
Practice Address - Country:US
Practice Address - Phone:919-460-8577
Practice Address - Fax:919-460-4418
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19714183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist