Provider Demographics
NPI:1588077499
Name:FRESCO, AMBER INGRAM (MD)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:INGRAM
Last Name:FRESCO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:MICHELLE
Other - Last Name:INGRAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:40 DUKE MEDICINE CIRCLE, CLINIC 3K
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-4000
Mailing Address - Country:US
Mailing Address - Phone:919-684-3432
Mailing Address - Fax:
Practice Address - Street 1:40 DUKE MEDICINE CIRCLE, CLINIC 3K
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710
Practice Address - Country:US
Practice Address - Phone:919-684-3432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-00476207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology