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Individual

AMANDA LEE WHITED

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D

Contact information

Practice address
115 HEART DR, ECU PHYSICIANS CARDIOTHORACIC SURGERY, GREENVILLE, NC 27834-8944
(252) 744-4400
(252) 744-3987
Mailing address
PO BOX 751069, ECU PHYSICIANS, CHARLOTTE, NC 28275-1069

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4584
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1306271739
NC
01
185UM
BCBS NC
NC
Enumeration date
09/04/2013
Last updated
09/24/2014
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