MEDICARE: DR. ERYN AMALIA CAAMANO STANSFIELD M.D., MOH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	233786	MA

General Provider Information

NPI Number	:	1134313125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERYN AMALIA CAAMANO STANSFIELD M.D., MOH

Provider Business Mailing Address
First Line	:	7238 6TH ST BLDG 249
Second Line	:
City	:	HILL AFB
State	:	UT
Zip	:	84056-5213
Country	:	US
Telephone Number	:	801-231-9559
Fax Number	:

Provider Business Practice Location Address
First Line	:	7238 6TH ST BLDG 249
Second Line	:
City	:	HILL AFB
State	:	UT
Zip	:	84056-5213
Country	:	US
Telephone Number	:	801-231-9559
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2007
Last Update Date	:	05/03/2018

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