Individual
AMANDA M WONNACOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1001 S GEORGE ST, 3RD FLOOR, YORK, PA 17403-3676
(717) 812-4005
(717) 812-2495
Mailing address
108 E CORRAL AVE, SOLDOTNA, AK 99669-7524
(907) 714-5640
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL17067
OR
207R00000X
Internal Medicine Physician
Primary
MD436414
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102307636
—
PA
01
—
2103270
HIGHMARK BLUE SHIELD
PA
Enumeration date
08/06/2007
Last updated
11/04/2016
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