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General NPI Number Information
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NPI Number | 1821522715
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Entity Type | Individual
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Provider Name | AMBER MCCRAY
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Gender | Female
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 05/17/2021
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Provider Practice Location Address
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Address Line | 270 BOBBY JONES EXPY STE 158
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City | AUGUSTA
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State | GA
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Zip | 30907-3086
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Country | US
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Telephone | 706-403-2806
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Fax |
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Provider Business Mailing Address
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Address Line | 916 HAMMOND DR
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-3270
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Country | US
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Telephone | 912-258-2629
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | CO115799
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License Number State | GA
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