Individual
AMANDA JEAN NEDERVELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
10 E HOSPITAL ST, MANNING, SC 29102-3153
(803) 433-3000
Mailing address
9740 MARSH WREN CT APT 208, LAKE WORTH, FL 33467-5282
(941) 773-7233
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
37733
SC
207R00000X
Internal Medicine Physician
DO.1638
AL
207R00000X
Internal Medicine Physician
OS13103
FL
Other
Enumeration date
04/25/2014
Last updated
01/19/2017
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