Individual
AMANDA COMBS PRINCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5047 GERRARDSTOWN RD STE 2B, INWOOD, WV 25428-3951
(304) 821-1444
(304) 821-1450
Mailing address
2500 FOUNDATION WAY, MARTINSBURG, WV 25401-9000
(304) 264-9202
(304) 264-9042
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23193
WV
207Q00000X
Family Medicine Physician
FC1277169
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810027357
—
WV
01
—
WV4074B987
MEDICARE PTAN
WV
Enumeration date
06/27/2007
Last updated
04/07/2022
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