Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 184104 | NC |
NPI | 1013279017 |
---|---|
Provider Name | Amanda Vaughn Saunders |
First Address | Raleigh, NC 27614-8069 |
Second Address | Durham, NC 27709-0152 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2012 |
Last Update Date | 02/06/2016 |