Individual
MRS. AMANDA ROSE PUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
451 HEALTH PKWY STE B, PAW PAW, MI 49079-8242
(269) 655-3065
Mailing address
601 JOHN STREET, BOX 42, KALAMAZOO, MI 49007
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004946
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5390069
BCBS
MI
Enumeration date
11/07/2006
Last updated
04/30/2025
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