Healthcare Provider Details

I. General information

NPI: 1205730470
Provider Name (Legal Business Name): AMNA AMJAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 BRIGHTWATER DR
LILLINGTON NC
27546-5156
US

IV. Provider business mailing address

320 MISTY GROVES CIR
MORRISVILLE NC
27560-8461
US

V. Phone/Fax

Practice location:
  • Phone: 910-766-7711
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: