Provider Demographics
NPI:1861409518
Name:PATRICK, AMY M (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:PATRICK
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:537 STANTON CHRISTIANA RD
Mailing Address - Street 2:SUITE 203 MID ATLANTIC GI CONSULTANTS
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713
Mailing Address - Country:US
Mailing Address - Phone:302-225-2380
Mailing Address - Fax:302-225-2388
Practice Address - Street 1:537 STANTON CHRISTIANA RD
Practice Address - Street 2:SUITE 203 MID ATLANTIC GI CONSULTANTS
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713
Practice Address - Country:US
Practice Address - Phone:302-225-2380
Practice Address - Fax:302-225-2388
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC10004732207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4237804OtherAETNA
DE0000714001Medicaid
DEF35016OtherBCBS
DEF35016OtherBCBS
685445D93Medicare PIN
F35016Medicare UPIN