Healthcare Provider Details

I. General information

NPI: 1851356133
Provider Name (Legal Business Name): PAUL J AMOROSO MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 10/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CREDENTENTIALS OFFICE MADIGAN ARMY MEDICAL CTR 9040 FITZSIMONS DRIVE, ATTN: MCHJ-CI
TACOMA WA
98431-0001
US

IV. Provider business mailing address

9040 FITZSIMONS DRIVE, ATTN: MCHJ-CI CREDENTENTIAL'S OFFICE, MADIGAN ARMY MEDICAL CENTER
TACOMA WA
98431
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-1160
  • Fax: 253-399-2882
Mailing address:
  • Phone: 253-968-1160
  • Fax: 253-399-2882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number56723
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: