Individual
AMANDA MARIE FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7349 STATESVILLE RD # B, CHARLOTTE, NC 28269-3702
(866) 550-3472
(704) 973-7875
Mailing address
8936 CYPRESS FOREST DR, CHARLOTTE, NC 28216-1674
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-08418
NC
Other
Enumeration date
11/09/2018
Last updated
12/19/2025
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