Individual
AMANDA MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1200 E MICHIGAN AVE STE 325, LANSING, MI 48912-1894
(517) 364-5160
Mailing address
PO BOX 13008, LANSING, MI 48901-3008
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006824
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601006824
MICHIGAN PHYSICIAN ASSISTANT LICENSE NUMBER
MI
Enumeration date
09/23/2013
Last updated
06/01/2021
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