Healthcare Provider Details

I. General information

NPI: 1770563397
Provider Name (Legal Business Name): PETER G NAPOLITANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 08/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLDG 9040 FITZSIMMONS DRIVE MCHJ-OG ATTN: LTC NAPOLITANO, DEPT OBGYN MADIGAN AMC
TACOMA WA
98431-0001
US

IV. Provider business mailing address

1305 SEQUALISH ST
STEILACOOM WA
98388-2517
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-3394
  • Fax: 253-968-5518
Mailing address:
  • Phone: 253-581-0665
  • Fax: 253-968-5518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberMD00033571
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberGFE72717
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number017273
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberM-11044
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: