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General NPI Number Information
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NPI Number | 1528061876
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Entity Type | Individual
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Provider Name | JOSEPH JAMES FAMMARTINO M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 03/15/2019
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Provider Practice Location Address
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Address Line | 4676 DOUGLAS CIR NW
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City | CANTON
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State | OH
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Zip | 44718-3619
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Country | US
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Telephone | 330-494-1116
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Fax | 330-494-0276
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Provider Business Mailing Address
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Address Line | 9800 LEVIN RD NW STE 203
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City | SILVERDALE
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State | WA
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Zip | 98383-7849
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Country | US
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Telephone | 360-307-0300
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Fax | 360-307-0302
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD2006-0840
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD60275755
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 35040894
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD040856E
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License Number State | PA
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