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General NPI Number Information
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NPI Number | 1063673853
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Entity Type | Individual
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Provider Name | AMY MARIE RAYNES M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/24/2008
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 400 W SEVENTH ST
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City | FREDERICK
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State | MD
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Zip | 21701-4506
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Country | US
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Telephone | 240-566-3251
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Fax |
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Provider Business Mailing Address
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Address Line | 204 LEE ST APARTMENT # 511
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City | GAITHERSBURG
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State | MD
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Zip | 20877-2947
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Country | US
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Telephone | 517-230-6798
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | PENDING
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License Number State | MD
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