Provider Demographics
NPI:1992533426
Name:WITMER, AMANDA Z (PA-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:Z
Last Name:WITMER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9711 SKYHILL WAY APT 403
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4834
Mailing Address - Country:US
Mailing Address - Phone:301-356-2027
Mailing Address - Fax:
Practice Address - Street 1:9711 SKYHILL WAY APT 403
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4834
Practice Address - Country:US
Practice Address - Phone:301-356-2027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0009464363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant