Provider Demographics
NPI:1104139344
Name:HORTON, AMANDA L (MD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:L
Last Name:HORTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9910 FRANKLIN SQUARE DR STE 2110
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4902
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:410-933-1390
Practice Address - Street 1:2700 REMINGTON AVE STE 2000
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211
Practice Address - Country:US
Practice Address - Phone:667-312-2400
Practice Address - Fax:410-367-2203
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD84592207V00000X
PAMD452259207V00000X
PAMT198031207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007278000OtherTPI MEDICAID GROUP
PACD4829OtherTPI GROUP RR MEDICARE
PA597586OtherTPI GROUP MEDICARE