Provider Demographics
NPI:1336239607
Name:WYATT, AMY (DO)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:WYATT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:15 HOSPITAL DR
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1011
Mailing Address - Country:US
Mailing Address - Phone:207-351-2170
Mailing Address - Fax:207-363-0120
Practice Address - Street 1:15 HOSPITAL DR
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1011
Practice Address - Country:US
Practice Address - Phone:207-351-2170
Practice Address - Fax:207-363-0120
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2008-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME1171207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine