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General NPI Number Information
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NPI Number | 1700927365
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Entity Type | Individual
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Provider Name | SAMANTHA TUTTAMORE PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 06/13/2011
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Provider Practice Location Address
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Address Line | 110 IRVING ST NW
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City | WASHINGTON
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State | DC
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Zip | 20010
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Country | US
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Telephone | 202-877-5580
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Fax |
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Provider Business Mailing Address
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Address Line | 9323 CEDAR LN
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City | BETHESDA
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State | MD
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Zip | 20814-3974
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Country | US
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Telephone | 773-220-7268
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA030322
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | C0002757
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License Number State | MD
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