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General NPI Number Information
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NPI Number | 1326570524
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Entity Type | Individual
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Provider Name | AMANDA JANE WARNER D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 03/28/2017
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Last Update Date | 11/11/2020
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Provider Practice Location Address
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Address Line | 103 SUMMIT CENTRE DR
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City | COLUMBIA
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State | SC
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Zip | 29229-7613
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Country | US
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Telephone | 803-356-4712
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Fax | 803-356-0832
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Provider Business Mailing Address
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Address Line | PO BOX 6069
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City | WEST COLUMBIA
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State | SC
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Zip | 29171-6069
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Country | US
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Telephone |
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 683
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 683
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License Number State | SC
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