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Individual

AMANDA S. YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
115 PORTER DRIVE, MIDDLEBURY, VT 05753
(802) 388-5607
(802) 388-5654
Mailing address
37 PORTER DRIVE, MIDDLEBURY, VT 05753
(802) 388-4705
(802) 388-5696

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
017053
ME
207P00000X
Emergency Medicine Physician
Primary
042-0011551
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1015136
VT
Enumeration date
11/01/2006
Last updated
10/01/2010
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