Healthcare Provider Details

I. General information

NPI: 1104139344
Provider Name (Legal Business Name): AMANDA L HORTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 09/16/2022
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 REMINGTON AVE STE 2000
BALTIMORE MD
21211
US

IV. Provider business mailing address

9910 FRANKLIN SQUARE DR STE 2110
BALTIMORE MD
21236-4902
US

V. Phone/Fax

Practice location:
  • Phone: 667-312-2400
  • Fax: 410-367-2203
Mailing address:
  • Phone: 410-933-6423
  • Fax: 410-933-1390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD84592
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: