Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | D92566 | MD |
N | 207X00000X | Orthopaedic Surgeon | L-251387 | MA |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | D92566 | MD |
NPI | 1457615916 |
---|---|
Provider Name | Amanda J. Mccoy |
First Address | Cumberland, MD 21501-1671 |
Second Address | Cumberland, MD 21502-3798 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2012 |
Last Update Date | 19/11/2021 |