Provider Demographics
NPI:1831180967
Name:APPLEGATE, AMANDA MAE (MD)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:MAE
Last Name:APPLEGATE
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 1:935 ELIZAVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:FLEMINGSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41041-9210
Mailing Address - Country:US
Mailing Address - Phone:606-849-3374
Mailing Address - Fax:606-845-0646
Practice Address - Street 1:935 ELIZAVILLE AVE
Practice Address - Street 2:
Practice Address - City:FLEMINGSBURG
Practice Address - State:KY
Practice Address - Zip Code:41041-9210
Practice Address - Country:US
Practice Address - Phone:606-849-3374
Practice Address - Fax:606-845-0646
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35836207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine