Individual
MICHELLE IRENE AMAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-0100
(843) 792-1414
(843) 792-1827
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
(843) 792-1827
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
17476
AL
208000000X
Pediatrics Physician
Primary
31238
SC
2080C0008X
Child Abuse Pediatrics Physician
31238
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000024694
—
AL
05
—
000028985
—
AL
05
—
009999735
—
AL
05
—
312389
—
SC
01
—
510-24694
BC BS
AL
01
—
F61561
VIVA
—
Enumeration date
07/16/2006
Last updated
05/20/2025
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