MEDICARE: AMANDA CAIN, MD, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	037770	GA

General Provider Information

NPI Number	:	1811165095
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMANDA CAIN, MD, PC

Provider Business Mailing Address
First Line	:	950 S ENOTA DR NE STE B
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-2439
Country	:	US
Telephone Number	:	770-531-0530
Fax Number	:	770-531-0491

Provider Business Practice Location Address
First Line	:	950 S ENOTA DR NE STE B
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-2439
Country	:	US
Telephone Number	:	770-531-0530
Fax Number	:	770-531-0491

Authorized Official
Title or Position	:	PRACTICE MGR
Name	:	ANNA STEWART
Credential	:
Telephone Number	:	770-531-0530

Provider Enumeration Date	:	02/11/2008
Last Update Date	:	03/17/2008

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