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General NPI Number Information
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NPI Number | 1033435656
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Entity Type | Individual
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Provider Name | AMANDA MARIE MOORE PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/08/2010
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 30265 COMMERCE DR UNIT 104
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City | MILLSBORO
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State | DE
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Zip | 19966-3594
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Country | US
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Telephone | 302-629-4787
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Fax | 410-860-9583
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Provider Business Mailing Address
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Address Line | PO BOX 69709
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City | BALTIMORE
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State | MD
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Zip | 21264-9709
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Country | US
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Telephone | 410-860-9583
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C5-0000701
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License Number State | DE
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