Individual provider · NPI-1

Antonio Amaya

Family Medicine · Camp Lejeune, NC

NPI number1912778002
StatusActive
Last updated in NPPESDec 9, 2025

Details

NPI
1912778002
Entity type
Individual (NPI-1)
Name
Antonio Amaya
Sex
Male
Sole proprietor
No
Enumeration date
Jan 9, 2024
Certification date
Dec 9, 2025
Last updated
Dec 9, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine2025-03729NCYes

Practice location

100 Brewster Blvd
Camp Lejeune, NC 28547-2575

Phone 910-450-4408

Mailing address

100 Brewster Blvd
Camp Lejeune, NC 28547-2575

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