Individual
AMANDA J PATCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5693 YMCA PARK DR W, FORT WAYNE, IN 46835-3280
(260) 469-6603
(260) 486-6123
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11015098A
IN
Other
Enumeration date
03/20/2012
Last updated
10/10/2022
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