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Individual

DR. AMANDA CAROL MCBANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
27961 US HIGHWAY 98, SUITE 20, DAPHNE, AL 36526-4702
(251) 621-6520
(251) 621-6521
Mailing address
27961 US HIGHWAY 98, SUITE 20, DAPHNE, AL 36526-4702
(251) 621-6520
(251) 621-6521

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME 105944
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009912557
AL
05
01524881
MS
01
51544031
BCBS - 1504 SPRINGHILL
AL
Enumeration date
10/17/2006
Last updated
07/18/2011
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