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Individual
MARY AMANDA INGHRAM
Active
Individual
MARY AMANDA INGHRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C06741
MD
363A00000X
Physician Assistant
PA-TF-0191
MA
Other
Enumeration date
03/04/2015
Last updated
12/08/2022
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