Provider Demographics
NPI:1871763003
Name:FAIRCHILD, AMY DAWN (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:DAWN
Last Name:FAIRCHILD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2000 REGENCY PKWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-8506
Mailing Address - Country:US
Mailing Address - Phone:919-880-6592
Mailing Address - Fax:919-882-8227
Practice Address - Street 1:2000 REGENCY PKWY
Practice Address - Street 2:SUITE 204
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8506
Practice Address - Country:US
Practice Address - Phone:919-880-6592
Practice Address - Fax:919-882-8227
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-04
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC99015272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry