Provider Demographics
NPI:1336192624
Name:NORTON, AMY B (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:B
Last Name:NORTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:125 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-2665
Mailing Address - Country:US
Mailing Address - Phone:304-624-7200
Mailing Address - Fax:304-554-0404
Practice Address - Street 1:165 SCOTT AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-8847
Practice Address - Country:US
Practice Address - Phone:304-554-0400
Practice Address - Fax:304-554-0404
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21773207N00000X
PAMD428812207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810006178Medicaid
PA102129866Medicaid
PA145436Medicare PIN
WVI57961Medicare UPIN
PA102129866Medicaid