DR. AMANDA R SELF


Address: 7th Comm Bn Hq Co Bas, Unit 35610, Fpo, AP 96606-5610
Phone: 3184020604

DR. AMANDA R SELF (NPI# 1669548673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1669548673
Entity Type Individual
Full Name DR. AMANDA R SELF
Credential M.D.
Practice Address 7th Comm Bn Hq Co Bas
Unit 35610
Fpo
AP 96606-5610
Mailing Address 3944 Highway 175
Frierson
LA 71027-2159
Practice Telephone 3184020604
Mailing Telephone 3184020604
Enumeration Date 2006-11-28
Last Update Date 2008-04-20
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208D00000X General Practice 01062935A IN Allopathic & Osteopathic Physicians

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Office Location

Street Address 7TH COMM BN HQ CO BAS
UNIT 35610
City FPO
State AP
Zip Code 96606-5610

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Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

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Competitor

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City FPO
Zip Code 96606

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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