Healthcare Provider Details

I. General information

NPI: 1154647949
Provider Name (Legal Business Name): AMANDA CAROLYN HEMMERICH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA CAROLYN LAYNE M.D.

II. Dates (important events)

Enumeration Date: 04/19/2010
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN RD
DURHAM NC
27710-6437
US

IV. Provider business mailing address

2301 ERWIN RD DUMC BOX 3712
DURHAM NC
27710-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-668-5138
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number2013-02516
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number35056
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: