Individual
DR. AMANDA NICKLES FADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6569 N CHARLES ST, SUITE 306, BALTIMORE, MD 21204-6831
(443) 849-2765
(443) 849-2946
Mailing address
PO BOX 418953, BOSTON, MA 02241-8953
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
D0069631
MD
207VX0201X
Gynecologic Oncology Physician
MT179962
OH
Other
Enumeration date
05/12/2008
Last updated
11/29/2011
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