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General NPI Number Information
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NPI Number | 1659454528
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Entity Type | Individual
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Provider Name | PAUL W. PUMILIA M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 3124 S 19TH ST # 140
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City | TACOMA
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State | WA
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Zip | 98405-2433
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Country | US
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Telephone | 253-459-6510
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Fax |
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Provider Business Mailing Address
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Address Line | 3124 S 19TH ST # 140
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City | TACOMA
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State | WA
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Zip | 98405-2433
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Country | US
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Telephone | 253-459-6510
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2001-01597
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD6045014
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License Number State | WA
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