Provider Demographics
NPI:1457347064
Name:ADAMS, AMANDA JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:JEAN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 447
Mailing Address - Street 2:
Mailing Address - City:EAST BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16029-0447
Mailing Address - Country:US
Mailing Address - Phone:724-284-7470
Mailing Address - Fax:
Practice Address - Street 1:300 NORTHPOINTE CIR
Practice Address - Street 2:
Practice Address - City:SEVEN FIELDS
Practice Address - State:PA
Practice Address - Zip Code:16046-7862
Practice Address - Country:US
Practice Address - Phone:724-741-2580
Practice Address - Fax:724-741-2583
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD441309207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA226589Medicare PIN