Individual
AMANDA QUINTINO MARTINS LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2300 N EDWARD ST, DECATUR, IL 62526-4163
(217) 876-3660
Mailing address
2300 N EDWARD ST, DECATUR, IL 62526-4163
(217) 876-3660
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036173578
IL
208M00000X
Hospitalist Physician
036173578
IL
Other
Enumeration date
08/22/2022
Last updated
08/21/2025
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