Healthcare Provider Details
I. General information
NPI: 1245344076
Provider Name (Legal Business Name): AMANDA FLICKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/18/2006
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3900 HAMILTON BLVD SUITE 201
ALLENTOWN PA
18103-6122
US
IV. Provider business mailing address
PO BOX 783311
PHILADELPHIA PA
19178-3311
US
V. Phone/Fax
- Phone: 484-664-7555
- Fax: 484-664-7550
- Phone: 484-884-4500
- Fax: 484-884-0699
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | MD421611 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: