Individual
AMANDA MARIE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
30265 COMMERCE DR UNIT 104, MILLSBORO, DE 19966-3594
(302) 629-4787
(410) 860-9583
Mailing address
PO BOX 69709, BALTIMORE, MD 21264-9709
(410) 860-9583
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C5-0000701
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033435656
COMMUNITY HEALTH PLAN
—
Enumeration date
04/08/2010
Last updated
10/02/2025
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