Provider Demographics
NPI:1982288643
Name:BINGHAM, AMY JUDITH (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:JUDITH
Last Name:BINGHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:704 WINDCREST RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-9753
Mailing Address - Country:US
Mailing Address - Phone:310-779-1623
Mailing Address - Fax:
Practice Address - Street 1:N2198, CB7010 UNC HOSPITALS
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-4226
Practice Address - Country:US
Practice Address - Phone:919-966-5136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRTL21-0089207L00000X, 390200000X
NC2022-02939207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program