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Individual
AMANDA MARIE PENNINGTON
Active
Individual
AMANDA MARIE PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20333
SC
207Q00000X
Family Medicine Physician
9300562
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080152242
RAILROAD MEDICARE
—
05
—
1144247099
—
NC
05
—
203336
—
SC
01
—
66763
BLUE CROSS BLUE SHIELD NC
NC
05
—
8966763
—
NC
Enumeration date
07/16/2006
Last updated
07/08/2014
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