Individual
DR. AMANDA FAYE NORTHUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
91-1051 FRANKLIN D ROOSEVELT AVE, KAPOLEI, HI 96707-2185
(808) 458-5065
Mailing address
91-1051 FRANKLIN D ROOSEVELT AVE, KAPOLEI, HI 96707-2185
(808) 458-5064
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL35918
SC
207RC0000X
Cardiovascular Disease Physician
Primary
35918
SC
Other
Enumeration date
06/14/2013
Last updated
01/23/2025
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