Provider Demographics
NPI:1295090942
Name:STEVENTON, AMANDA R (MD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:R
Last Name:STEVENTON
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Gender:F
Credentials:MD
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Mailing Address - Street 1:10900 WORLD TRADE BLVD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-4202
Mailing Address - Country:US
Mailing Address - Phone:919-237-1337
Mailing Address - Fax:919-237-1625
Practice Address - Street 1:400 ATTAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-2702
Practice Address - Country:US
Practice Address - Phone:984-377-8675
Practice Address - Fax:984-377-8687
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2022-06-06
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Provider Licenses
StateLicense IDTaxonomies
KS9408008207Q00000X
NC2019-02631207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine