Provider Demographics
NPI:1992457964
Name:MARLER, AMANDA D (CNM)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:D
Last Name:MARLER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1062 FORSYTH ST STE 3B
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-8640
Mailing Address - Country:US
Mailing Address - Phone:478-743-3454
Mailing Address - Fax:
Practice Address - Street 1:1062 FORSYTH ST STE 3B
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-8640
Practice Address - Country:US
Practice Address - Phone:478-743-3454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA210692207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology