Individual
DR. AMANDA J STORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4650 JEFFERSON LN NE, ALBUQUERQUE, NM 87109-2127
(505) 727-7900
(505) 727-7942
Mailing address
4650 JEFFERSON LN NE, ALBUQUERQUE, NM 87109-2127
(505) 727-7900
(505) 727-7942
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
89-310
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00017723
—
NM
01
—
920004601
MEDICARE RAILROAD
NM
Enumeration date
06/15/2005
Last updated
09/30/2015
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