Provider Demographics
NPI:1487087052
Name:HERSH, AMANDA JO (DO)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:JO
Last Name:HERSH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:M263 MEDICAL SCIENCE BUILDING ONE HOSPITAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65212-9498
Mailing Address - Country:US
Mailing Address - Phone:573-882-3014
Mailing Address - Fax:
Practice Address - Street 1:M263 MEDICAL SCIENCE BUILDING ONE HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-9498
Practice Address - Country:US
Practice Address - Phone:573-882-3014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-18
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO0004948207R00000X
MO2015036302207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine