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Individual

DR. AMANDA LARA STOREY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4500 MAIN ST, GRANT, AL 35747-8303
(256) 728-8600
(256) 728-8602
Mailing address
PO BOX 11407 DEPT# 0132, BIRMINGHAM, AL 35246-0132
(256) 728-8600
(256) 728-8602

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32410
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000150826
AL
01
0108154
UNITED HEALTHCARE
01
1927094
CIGNA
01
51135954
BLUE CROSS BLUE SHIELD
AL
05
5906772
NC
01
7633871
AETNA
01
809199
PARTNERS
01
P00428736
MEDICARE RAILROAD
Enumeration date
01/08/2007
Last updated
11/06/2017
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