MEDICARE: ASTRID MARIE PUJARI MD

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	207R00000X	Internal Medicine Physician	MD00040267	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6702PU	OTHER	WA	BLUE SHIELD VM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	US2578151	OTHER	WA	AETNA PCP PIN VM
5	US2578155	OTHER	WA	AETNA SPECIALIST PIN VM

General Provider Information

NPI Number	:	1376641563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASTRID MARIE PUJARI MD

Provider Business Mailing Address
First Line	:	1370 STEWART ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98111
Country	:	US
Telephone Number	:	206-344-8053
Fax Number	:	206-344-7112

Provider Business Practice Location Address
First Line	:	1370 STEWART ST
Second Line	:	PUJARI CENTER
City	:	SEATTLE
State	:	WA
Zip	:	98101
Country	:	US
Telephone Number	:	206-344-8053
Fax Number	:	206-344-7112

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	05/30/2008

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