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General NPI Number Information
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NPI Number | 1245437979
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Entity Type | Individual
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Provider Name | AMANDA COMBS PRINCE M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 04/07/2022
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Provider Practice Location Address
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Address Line | 5047 GERRARDSTOWN RD STE 2B
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City | INWOOD
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State | WV
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Zip | 25428-3951
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Country | US
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Telephone | 304-821-1444
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Fax | 304-821-1450
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Provider Business Mailing Address
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Address Line | 2500 FOUNDATION WAY
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City | MARTINSBURG
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State | WV
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Zip | 25401-9000
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Country | US
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Telephone | 304-264-9202
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Fax | 304-264-9042
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | FC1277169
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 23193
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License Number State | WV
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