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General NPI Number Information
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NPI Number | 1902484959
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Entity Type | Individual
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Provider Name | AMANDA BRADY HALL DO
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Gender | Female
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Dates
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Enumeration Date | 03/31/2021
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 1 SAINT FRANCIS DR
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City | GREENVILLE
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State | SC
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Zip | 29601-3955
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Country | US
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Telephone | 864-255-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 CUMMINS DR STE D
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City | MODESTO
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State | CA
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Zip | 95358-6411
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 25MB12092500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 94718
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License Number State | SC
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Taxonomy #3
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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 |
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