Individual
AMANDA GOHLKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1401 JOHNSTON WILLIS DR, NORTH CHESTERFIELD, VA 23235-4730
(804) 483-5155
Mailing address
PO BOX 980662, PATH: PATHOLOGY AP/CP, RICHMOND, VA 23298-0662
(804) 628-1690
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
MT201300
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
D0085010
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
VA
Other
Enumeration date
06/15/2012
Last updated
06/03/2023
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