Healthcare Provider Details

I. General information

NPI: 1154647733
Provider Name (Legal Business Name): AMANDA RENEE HINKLE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMANDA RENEE SMITH

II. Dates (important events)

Enumeration Date: 04/08/2010
Last Update Date: 07/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 HOAGIE DR
BEL AIR MD
21014-1884
US

IV. Provider business mailing address

604 HOAGIE DR
BEL AIR MD
21014-1884
US

V. Phone/Fax

Practice location:
  • Phone: 410-893-4844
  • Fax:
Mailing address:
  • Phone: 410-893-4844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0075683
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: