Provider Demographics
NPI:1699936161
Name:ROBERTSON SHEPHERD, AMANDA JO (MD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:JO
Last Name:ROBERTSON SHEPHERD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 EMERGENCY DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-6804
Mailing Address - Country:US
Mailing Address - Phone:336-932-0895
Mailing Address - Fax:
Practice Address - Street 1:510 EMERGENCY DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-6804
Practice Address - Country:US
Practice Address - Phone:336-932-0895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC148942207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery