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General NPI Number Information
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NPI Number | 1730379595
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Entity Type | Individual
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Provider Name | AMANDA D. VUPPALA M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 394 SINGLETON RIDGE RD
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City | CONWAY
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State | SC
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Zip | 29526-9150
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Country | US
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Telephone | 843-347-8050
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Fax | 843-347-8049
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Provider Business Mailing Address
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Address Line | 300 SINGLETON RIDGE RD ATTN CREDENTIALING
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City | CONWAY
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State | SC
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Zip | 29526-9142
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Country | US
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Telephone | 843-234-6946
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | MD.201465
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 33517
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License Number State | SC
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