Healthcare Provider Details

I. General information

NPI: 1588660351
Provider Name (Legal Business Name): AMANDA SUE FICHTER OD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N GRANT AVE STE A
WILMINGTON DE
19805-2671
US

IV. Provider business mailing address

1100 N GRANT AVE STE A
WILMINGTON DE
19805-2671
US

V. Phone/Fax

Practice location:
  • Phone: 302-655-3388
  • Fax: 302-655-2199
Mailing address:
  • Phone: 302-655-3388
  • Fax: 302-655-2199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: