MEDICARE: DR. AMBER MACKENZIE WHITED-WATSON DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	34.012664	OH

General Provider Information

NPI Number	:	1477700912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMBER MACKENZIE WHITED-WATSON DO

Provider Business Mailing Address
First Line	:	47185 COOPER FOSTER PARK RD
Second Line	:
City	:	AMHERST
State	:	OH
Zip	:	44001-3307
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	47185 COOPER FOSTER PARK RD
Second Line	:
City	:	AMHERST
State	:	OH
Zip	:	44001-3307
Country	:	US
Telephone Number	:	440-960-3954
Fax Number	:	440-960-3956

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2008
Last Update Date	:	12/30/2025

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