Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 57062 | CO |
Y | 2080P0202X | Pediatric Cardiologist | 04-43451 | KS |
NPI | 1093057366 |
---|---|
Provider Name | Dr. Amanda Marie Mcintosh |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108-4619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2013 |
Last Update Date | 21/07/2020 |