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DR. AMANDA NICKLES FADER MD NPI 1770750598


NPI Information

NPI: 1770750598
Provider Name: DR. AMANDA NICKLES FADER, MD
Classification: Obstetrics & Gynecology - 207VX0201X
Entity Type: Individual

Specialization: Gynecologic Oncology

PECOS Registration: Yes

Address:
6569 N CHARLES ST
SUITE 306
BALTIMORE, MD
ZIP 21204
Phone: (443) 849-2765
Get Directions

DR. Amanda Nickles Fader, MD is a gynecologic oncology obstetrics gynecology in Baltimore, MD with 22 years of experience. The provider is an obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. DR. Amanda Nickles Fader, MD NPI is 1770750598. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: VIRGINIA COMMONWEALTH UNIVERSITY, SCHOOL OF MEDICINE
Graduation Year:2002

The provider's business location address is:

6569 N CHARLES ST
SUITE 306
BALTIMORE, MD
ZIP 21204-831
Phone: (443) 849-2765
Fax: (443) 849-2946

The NPI 1770750598 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/12/2008 and was last updated on 11/29/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207VX0201XObstetrics & GynecologyGynecologic OncologyMT179962OHIONo
2207VX0201XObstetrics & GynecologyGynecologic OncologyD0069631MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1712L/163900YBPGMEDICARE PINMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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