MEDICARE: DR. JOSHUA SHIGERU YAMAMOTO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	MD035778	DC
2	207RC0000X	Cardiovascular Disease Physician	D0051320	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01143959	OTHER	DC	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1639172174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA SHIGERU YAMAMOTO M.D.

Provider Business Mailing Address
First Line	:	3301 NEW MEXICO AVE NW
Second Line	:	STE 202
City	:	WASHINGTON
State	:	DC
Zip	:	20016-3627
Country	:	US
Telephone Number	:	202-243-0271
Fax Number	:	202-537-0075

Provider Business Practice Location Address
First Line	:	3301 NEW MEXICO AVE NW
Second Line	:	STE 202
City	:	WASHINGTON
State	:	DC
Zip	:	20016-3627
Country	:	US
Telephone Number	:	202-243-0271
Fax Number	:	202-537-0075

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2005
Last Update Date	:	11/03/2016

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